Psychosis & Schizophrenia 精神分裂症和其他精神病性障碍

Case History
John (not his real name), a 23-year-old student at the National University of Singapore, was escorted by the police and his parents to the emergency department of Woodbridge Hospital. John who stays with his parents in their 4-room HDB flat on the tenth floor, had tried to jump out of the window of his bedroom. He was thwarted by his father who caught him by his clothes as he was climbing out of the window. A struggle followed and in the ensuing commotion, a neighbour called the police who managed to pull John back to safety. When he was assessed by the psychiatrist, John was dishevelled and obviously had not shaved for many days. At times, during the interview, he would in mid-sentence, turn his head and shout angrily. His speech was rambling and circumstantial and difficult to follow at times. He believed that the government and the CIA were keeping him under surveillance and were monitoring his movements with special X-ray machines. He would hear “voices” which he thought belonged to the agents watching him. These voices would threaten to arrest him but at other times they would mock him.

His parents related that they noticed something was amiss in the middle of his first year of university. Until then, he had been a good student. There had been no childhood history of any significant medical illness. In his early school years, he seemed to be rather timid. He played and interacted less with others than most children do. He completed his stint of National Service without any problems. The first noticeable change as registered by his parents was that he seemed more irritable and began to spend more time in his room. He stopped going out with his few friends and went out only for his classes. He became increasingly withdrawn and attempts to engage him were met with sullen silences. He became more unkempt in his dressing and could be heard walking around in his bedroom late at night and muttering to himself. He began yelling at imaginary people to leave him alone. Baffled and alarmed by these changes, his parents finally brought him to a local temple medium who pronounced John to have been under some malevolent spell. The temple medium gave him a talisman but that same night, John tried to jump out of the window.

from SCHIZOPHRENIA by Chong Siow Ann 


The earlier the illness is recognized and treated, the better the chances of making a full recovery.

Psychosis can be treated
We can help

Call 63892972


Psychosis describes a condition that affects the mind. It is characterized by some loss of contact with reality, and affects thoughts, perceptions, feelings, mood, behavior and communication.

A person who has a psychotic illness may have delusions, hallucinations or disordered thinking and disturbances in behavior. When someone becomes ill in this way, it is called a psychotic episode.


Psychosis is mostly likely to occur in young adults and is fairly common. Around 1 out of every 50 young people will experience a psychotic episode in their lifetime.


Psychosis can happen to anyone. Like any other illness it can be treated. But the earlier psychosis is recognized and treated, the better the chances of full recovery.


It is due to chemical imbalance in the brain, leading to a disruption of brain functioning.

Some possible factors contributing to a psychotic episode are

Physical illness
Environmental factors
Genetic predisposition

Psychosis is a medical condition. It’s a common illness that can be treated successfully with modern medicine, and the care of family and friends.

Psychosis does not cause you to lose your friends. The support of friends and family is an important key to recovery.


The onset of psychosis is usually in late adolescence an early adulthood. The symptoms of the illness can develop slowly over months or years.

Some early warning signs include:

Increased avoidance of contact with people
Deterioration of academic or work performance
Difficulty sleeping or concentrating
Lack of initiative, interest or energy in daily activities
Odd beliefs
Feeling that people are “talking about or following me”
Hearing or seeing something that isn’t there
Peculiar behavior e.g. talking, laughing, smiling to oneself
Neglecting personal appearance or hygiene
Irrational, angry or fearful response to loved ones


Early treatment will lead to a better and faster recovery. It may also prevent increasing the severity of the illness and in some cases, suicide.

Some other benefits include:

Less disability (physical, mental, psychological, social and occupational)
Lower risk of relapse
Fewer forensic complications
Reduced family disruption and distress
Reduced need for inpatient care
Lower health costs

Early Psychosis Intervention Programme (EPIP) is a national programme funded by the Ministry of Health and aims to maximize potential bebefits of early intervention through a comprehensive and integreated treatment approach.


Day Programme
In-patient and out-patient services
Family Care Group
Early Psychosis Screening

If you or someone you know is experiencing any symptoms suggestive of psychosis, consult a doctor for an opinion as soon as possible.

For general enquiries please call:

Department of Early Psychosis Intervention

Tel: 63892972
Mon – Fri, 8am – 5pm

Schizophrenia by Psychiatrist Ang Yong Guan 

 Schizophrenia affects 1 per cent of the population. This short video clip helps viewers to understand Schizophrenia; its main clinical features and treatment available. The story of Prof Elyn Saks, Professor of Law at the University of Southern California, is mentioned in this video clip for viewers to understand that there is hope even for sufferers of Schizophrenia

Schizophrenia - 精神分裂症 - Insights and Info into Mental Issues

-->Dr Ang Yong Guan (洪永元医生) discusses Schizophrenia in this documentary below. The first part features the clinical symptoms of Schizophrenia.

洪永元医生 Schizophrenia 精神分裂症 Ang Yong Guan Pt 1_2 (26 May 2005)

The 2nd part features recovered patients; one of them is Harris Ng.
洪永元医生 Schizophrenia 精神分裂症 Ang Yong Guan Pt 2_2 (26 May 2005) 

  This Chinese video clip below features the tragic story of Ah Nai, a man who has to looked after his family of 5 children (2 boys and 3 girls; all of whom have mental illness; 2 of them committed suicide) and his wife who is also mentally ill. It clearly illustrates the genetic basis of Schizophrenia which affects 1% of the population.

洪永元医生 Schizophrenia 精神分裂症 The story of Ah Nai Ang Yong Guan (31 Oct 2005)


What’s Real and What’s Not?

by Health Promotion Board
3 Second Hospital Avenue Singapore 168937

Copyright HPB B ECMT 595-09
September 2009


1.     What is Schizophrenia?
2.     What Are the Symptoms of Schizophrenia?
3.     What Causes Schizophrenia?
4.     What Are the Treatments Available?
5.     When To Seek Help?
6.     Coping With Schizophrenia
7.     Caring For Someone With Schizophrenia
8.     Where To Get Help

What Is Schizophrenia?

Schizophrenia is a serious medical condition that interferes with a person’s thinking processes and disrupts normal thoughts, speech and behavior.

Schizophrenia is a psychosis which is characterised by:

Hallucinations: seeing or hearing things that other people cannot see or hear, and

Delusions: holding beliefs that are odd or untrue

People with schizophrenia often withdraw from people and activities, retreating to their own inner world.

Schizophrenia is a chronic condition, requiring lifelong treatment. With new medications, schizophrenia symptoms can often be successfully managed, allowing people with the condition to lead productive, enjoyable lives.

The symptoms of schizophrenia range form mild to severe and may very from person to person. Some people may be able to function well in daily life while others need specialized, intensive care.

The onset of symptoms may also vary. Some experience a sudden appearance of symptoms, whereas for others, it may occur gradually over a few months.

Common symptoms include

a)    Hallucinations: Things that a person sees, hears, smells or feels that no one else can see, hear, smell or feel. Voices are the most common type of hallucination in schizophrenia. These voices may seem to give you instructions on how to act.
b)   Delusions: False personal beliefs that are not shared by others. For example, believing that there is a conspiracy against you.
c)    Thought disorder and incoherent speech: The ability to think clearly and logically is affected. There may be difficulty speaking at the same time, such as stopping in mid-sentence or speaking in a jumble of meaningless words.
d)   Absence of normal behavior: Lack of emotions, flat or blunted expression of emotions, emotions that are inappropriate to the situation. There may be apathy or social withdrawal.
e)    Cognitive symptoms: Problems with memory and attention, and may interfere with the ability to perform routine daily tasks such as difficulty paying attention, and making sense of information.

What Causes Schizophrenia?

Schizophrenia is a complex disease for which there is no single specific known cause. However, it is believed to result from an interaction of environment and genetics.

What Are The Treatments Available?

People with schizophrenia are usually given a combination of medication and psychosocial interventions:


Medication is essential for the effective treatment of schizophrenia, and it works best when combined with psychosocial therapy.

What You Need To Know About Your Medication Treatment:

Schizophrenia is a chronic condition that requires long term treatment. It is important to keep taking your medication even when you feel better to prevent the relapse of symptoms.

Which medication is best for you depends on your own individual situation.

It can take several weeks after first starting a medication to notice an improvement in your symptoms.

Psychosocial Interventions

Psychosocial interventions include Cognitive Behavioural Therapy (CBT), Occupational Therapy (OT) or Social Skills Training, and are tailored to help you re-adjust to society and to provide the best chance of recovery.

Developing a trusting relationship with your doctor is important in the recovery process.

Benefits of Treatment

Treatment is aimed at reducing symptoms and preventing psychotic relapses and is believed to be most effective when started early in the course of schizophrenia.

By following your treatment plan, you can function well in your daily activities and have a good chance of leading a productive life.

Treatment with medications and psycho-social therapy can help you take control of your condition and become an active participant in your own care and treatment.

When To Seek Help?

You may not recognize that you have the symptoms or that you need help. Family and friends are usually the ones who may suggest you seek help.

Schizophrenia does not get better on its own – it usually worsens without treatment. So listen to your family, they can help you to take the first steps to early treatment, which may increase your chance of recovery.

If you have any symptoms of schizophrenia, consult a doctor as soon as possible to get advice and a recommendation on the appropriate treatment.

Coping With Schizophrenia

Schizophrenia isn’t an illness that you can treat on your own and it is vital not to face the illness alone. You can do some things for yourself that will reinforce your treatment plan.

(a) Take your medications as directed. Even if you are feeling better, resist any temptation to skip your medications. IF you stop, schizophrenia symptoms are likely to come back.
(b) Pay attention to warning signs. You and your caregivers may have identified things that may trigger the symptoms, cause a relapse or prevent you from carrying out your daily activities. Make a plan so that you know what to do if symptoms return. Contact your doctor or therapist if you notice any changes in symptoms or how you feel.
(c)  Involve family members or friends in watching out for warning signs. Addressing schizophrenia symptoms earlier on can prevent the situation from worsening.
(d) Join support groups. They can be a continuing source of mutual support, facilitating information and resource sharing. They also play an important role of encouraging you to return to social and functional activities (e.g. school, work).
(e) Stay informed about schizophrenia and its treatments. Education about your condition can empower you can motivate you to stick to your treatment plan.
(f)  Stay focused on your recovery goals.  Treatment for schizophrenia is an on-going process. Stay motivated by reminding yourself that you are responsible for managing your illness.
(g) Adopt good health practices. Following a sensible diet and regular exercise will be beneficial. Stay away from drugs and alcohol – they can worsen schizophrenia symptoms and interfere with the effectiveness of medications.

Caring For Someone With Schizophrenia

It is normal to feel overwhelmed when taking care of someone with schizophrenia and it may sometimes be difficult to cope with the additional responsibilities of catering to their needs.

Do not give up. Your support and understanding is very important in your loved ones’ road to recovery from schizophrenia and also in the prevention of future relapses.

Although you cannot help to cure the disease, you can help them to manage their illness and regain their ability to function in their daily lives.

How can you help?

1.     Help them to set realistic goals.
2.     Learn about the signs and symptoms of schizophrenia, so that you know what to expect and help reduce the likelihood of relapses.
3.     Look out for the signs of suicidal thoughts or actions.
4.     Be patient and supportive. Continue to communicate and stay alert to their needs.

Consult a doctor if you are experiencing symptoms or wish to help.

To locate a hospital or a clinic near your home that is on the Chronic Disease Management Programme (CDMP), visit

From 1 Oct 2009, the Medisave for Chronic Disease Management Programme will be extended to include Major Depression and Schizophrenia. The scheme will allow patients with these mental illnesses to use their Medisave to help pay part of their treatment bill.

For information on CDMP, call the Healthline at 18002231313 to speak to a Nurse Advisor (available in 4 languages) or visit
Disclaimer: This booklet has been written primarily for people with schizophrenia and their caregivers and family members. It is not meant to be a substitute for professional medical advice and care.

Keep an open mind about schizophrenia

Here's the truth behind some common misconceptions:

Very few people have schizophrenia - FALSE

One in 100 people is diagnosed with the condition - that makes it as common as autism and more prevalent than Parkinson's and multiple sclerosis.

It's a multiple personality disorder - FALSE

This myth isn't helped by inaccurate depictions of schizophrenia in films like Me, Myself and Irene, a comedy made in 2000 with Jim Carrey.

Schizophrenia comes from two Greek words meaning "split" and "mind" but it doesn't mean multiple personalities.

It happens when the parts of the brain responsible for emotion and sensation stop working properly. Hearing voices - usually critical or controlling ones - is a common symptom, while some people see, feel or smell things that aren't there.

Delusions, such as when someone might believe they're being sent messages via the TV, are common too. Other symptoms may be less obvious, such as becoming very withdrawn.

A better film depiction is A Beautiful Mind, in which Russell Crowe plays John Nash, a real-life Nobel prize-winning economist diagnosed with schizophrenia. But, as with any illness, symptoms vary.

Cannabis can cause it - NOT EXACTLY

Drugs can trigger the condition but don't cause it directly. However, if someone is predisposed to develop schizophrenia, cannabis - particularly skunk - LSD, cocaine and amphetamines can bring it on, and can make existing symptoms worse.

Smoking skunk in your teens can quadruple your risk of schizophrenia. Very stressful events like bereavement or abuse may trigger it too.

The trouble is, it's impossible to know if you have a predisposition. Research suggests that genes and a brain chemical imbalance are involved.

It runs in families - TRUE

Although no single gene has been identified, studies show that, if one of your parents has a history of schizophrenia, your chance of developing the condition is one in 10 - 10 times that of someone with no family history.

If an identical twin has it, there's a 50 in 100 chance the other twin will develop it, compared with a 15 in 100 chance for a non-identical twin. Most people who've been diagnosed have no relatives with the condition.

You may only be ill once - TRUE

A quarter of all sufferers only have one acute episode in their life, while two-thirds will have long periods of being well with occasional episodes. Only 10 to 15% of people are severely affected in the long term.

The aim is to manage the condition, often by a combination of medication, talking therapies, avoiding potential triggers such as alcohol or stress, and learning to spot early signs of illness.

Violence is part of the illness - FALSE

Violence isn't a symptom of the illness but stories involving violence always hit the news. In cases of murder by a stranger, only four in 100 are committed by someone with schizophrenia, and these tend to involve substance abuse or poor mental health care.

Any violence is far more likely to be self-directed, with around a third of sufferers attempting suicide.

Most of us can work and have fulfilling relationships


Breaking out of the mental prison
Salma Khalik
Sat, Sep 22, 2007
The Straits Times

One in 100 people suffers from this mental condition. Over 16,000 people with this condition cope with it daily, holding down a job or going to school. Health Correspondent SALMA KHALIK looks at those with schizophrenia, who face a lifelong struggle to get out of their mental prison to lead near-normal lives


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