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Recognising Psychosis

Psychosis happens when a person loses touch with reality. Read on to learn more about the symptoms of this condition.  

 Psychosis is not a specific illness, rather it is a syndrome. The central characteristic of psychosis is a loss of reality testing, resulting in some degree of impairment of judgement. Psychotic symptoms may present with a disturbance of perception, such as hallucinations (where they hear voices or see things that do not exist) or disturbance of thinking, such as disordered thinking or delusions (false beliefs that they are going to be harmed or that people are talking about them). 

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Symptoms

Even before the onset of clear psychotic symptoms that are characteristic of psychosis, there is usually a period with some changes in mood, thinking or behaviour along with a deterioration in functioning that precedes it.   

Some of these symptoms include: 

  • Perceptual disturbances such as feelings that things around have changed 
  • Mood disturbances such as anxiety, depression, mood swings, irritability and anger 
  • Cognitive disturbances such as poor attention and concentration, difficulties in thinking, suspiciousness and unusual beliefs 
  • Behavioural disturbances such as change in sleep and appetite patterns, social withdrawal, loss of interest in things, deterioration in occupation and academic functioning 

Different people will probably interpret these disturbances differently. Some may see them as symptoms of stress, especially if the changes are associated with some stressful life events. Others may see them as part of the person’s personality. Cultural influences may also play a part in how the symptoms of psychosis might be interpreted. Psychotic symptoms are often attributed to supernatural causes rather than biological causes.  

One’s personal understanding of the disturbances will determine if an individual will seek help. Even for those who suspect that it may be a mental condition, the stigma of seeking psychiatric help may deter them from consulting a psychiatrist. It is not surprising that there is often a long delay, sometimes even a few years, before the person reaches out for professional help. 
 

Causes

The exact causation of psychosis is thought to be related to neurological and biochemical changes that occur in a person’s brain during their teenage and early adulthood years. 

Someone who has a close family member who has a psychotic illness, the use of recreational drugs or a history of intermittent brief psychotic symptoms may predispose someone to developing a psychotic disorder. However, most people suffering from a psychotic disorder do not have these risk factors. 

If changes in the individual’s behaviour and functioning are observed and the individual also has associated risk factors as mentioned above, it would be best to refer him early for further evaluation to see if he has psychosis, and for treatment if necessary.  


Treatment / Help available

Research shows that early detection – and treatment – of psychosis is associated with a better prognosis.  It can be treated and most people make a full recovery.  

There are new and effective medicines, as well as improved treatment programmes that optimise recovery and functioning and which contribute to a better outcome for individuals with psychosis. 

Besides medication, counselling, and psychotherapy, practical assistance such as getting help with school or work and arranging accommodation are other important aspects of treatment. 


Specialised Programme

The Early Psychosis Intervention Programme at the Institute of Mental Health (IMH) emphasises early detection and treatment. The team works closely with healthcare professionals in other hospitals, polyclinics and social agencies to help spot the early signs of mental disorders among those aged 16 – 40. EPIP also works with educational institutions and youth workers to identify the onset of psychosis among young people. 

These partners help refer patients to IMH or, if applicable, jointly assess them. At EPIP, every outpatient is assigned a case manager who will assist in managing their overall needs. Psychosis can be treated with medication, psychological support and good family support.  

Besides seeing clients at outpatient clinics, EPIP emphasises psychosocial programmes that help clients in their recovery. Groups and day activities are run at Club EPIP, which help to address issues relating to social skills, stigma, leading a healthy lifestyle and cognitive remediation, just to name a few. The aim of these is to help clients to return to their appropriate role and engage in meaningful activities. For more information, please visit EPIP's website at www.epip.org.sg or contact EPIP at 6389-2972 between 9am to 5pm on Mondays to Fridays for enquiries. 

IMH also provides assessment and treatment for psychosis in individuals of other age groups. To make an appointment to see a doctor, please call the IMH appointment line at 6389-2200. 

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