Six things to know about schizophrenia

1. It is a complex and chronic brain disorder that affects how a person thinks, feels and behaves. While there is no cure, it can be treated and managed with medication, therapy and self-help strategies.

At the Institute of Mental Health (IMH), almost 60 per cent to 70 per cent of patients with schizophrenia make a good recovery and return to the community, said Associate Professor Swapna Verma, IMH’s medical board chairwoman. 

About 10 per cent to 20 per cent do not do as well and need to be supported in the community, while the remaining 20 per cent or so continue to worsen, with some needing to remain in hospital over the long term, she said.

2. Schizophrenia symptoms include:

- Positive symptoms, which refer to behaviour or thoughts that were not there before the illness began. These include the patients hearing voices or seeing things that do not exist, or believing that others are out to harm them. Some patients may have grandiose thoughts – that they are famous when it is not the case, for instance – and other firm but false beliefs.

- Negative symptoms, which refer to the absence of behaviour or emotions the patients once had. They may show very little emotional expression, speak in a monotone or hardly at all. They may withdraw from social contact and lose motivation to pursue goals and activities.

- Symptoms of disorganisation, such as the inability to think clearly and respond to others appropriately, and problems with routine tasks like dressing and bathing.

- Other symptoms, such as cognitive impairment – problems with attention, concentration, memory and declining educational performance – and mood issues such as depression, which can set in when they realise their brains cannot function as before.

3. In Singapore, schizophrenia affects about one in 116 people (0.86 per cent). Depression, the most common psychiatric disorder among adults in Singapore, affects one in 16 people. While schizophrenia is not as common as depression and anxiety, it can lead to a much higher level of impairment and disability, as well as death.

4. Many people with schizophrenia do not know they have a mental health condition and may not believe they need treatment. Prof Swapna says she spends a lot of time talking to patients in their late teens and early 20s to get them to see that they have a brain illness for which they need to take medication.

“They feel the symptoms are all very real to them, and they will say: ‘I really know that these people are calling, my phone is tapped. How can you prove it’s not true?’” she said. “So I tell them: ‘But it is affecting your functioning. These symptoms are stopping you from going to school... Allow us to treat you.’”

5. Some people may think that those with schizophrenia are dangerous, but they are not any more dangerous or violent than people in the general population. However, suicidal thoughts and attempts are much higher than average in people with schizophrenia. 

6. Schizophrenia is the most severe psychotic condition. A person might experience it once, have short episodes in his or her lifetime, or live with it most of the time. People living with other mental disorders such as bipolar disorder or severe depression can experience it too. It can also be triggered by drug or alcohol misuse, a head injury or a neurological condition such as dementia, among other things.