Schizophrenia is characterised by multiplicity of symptoms affecting cognition, emotion and perception. The early age of onset, varying degree of intellectual and psychosocial impairment and possibility of long-term disability makes it a severe and devastating mental illness. Symptoms of schizophrenia are divided into four categories: positive, negative, disorganised and cognitive symptoms. Various combinations of severity of these four categories are found in patients. They may also experience symptoms of other mental disorders, including depression, obsessive and compulsive symptoms, somatic concerns, and mood or anxiety symptoms. More than 80% of patients with schizophrenia have parents who do not have the disorder. The risk of having schizophrenia is greater in persons whose parents have the disorder. The peak incidence of schizophrenia is at 21 years. The onset is earlier for men (between ages 15 and 25 years) and later in women (between ages 25 and 35 years). Childhood onset schizophrenia is rare. The first psychotic episode is often preceded by a prodromal phrase lasting weeks or even years. The psychotic phase progresses through an acute phase, a recovery or stabilisation phase, and a stable phase. Early detection and treatment results in a better outcome. Management of schizophrenia is holistic and multidisciplinary. Family physicians play an important role in the early detection of those who are psychotic; managing patients who are stabilised and require maintenance pharmacotherapy; and the detection of physical illnesses of cardiovascular diseases, obesity and diabetes which have a higher prevalence among patients with schizophrenia as compared to the general population.

Humans ; Mental Disorders ; epidemiology ; Mental Health Services ; trends ; Singapore ; epidemiology

Humans ; Preventive Psychiatry ; Psychotic Disorders ; etiology ; prevention & control ; Risk Assessment

Chronic Disease ; Comorbidity ; Humans ; Mental Disorders ; epidemiology

Psychoses are serious and potentially chronic mental disorders with a profound impact, in terms of economic cost and human suffering, on patients, their families and society. Early detection and treatment, through reducing the duration of untreated psychosis, however, could lead to a better outcome. In 2001, the Early Psychosis Intervention Programme (EPIP), Singapore was started with the following key strategies: (1) early detection of psychosis through outreach to and network with the community and our partners; (2) provision of clinical treatment that is evidence-based; and (3) conducting clinically relevant research to evaluate our service to be accountable to the stake-holders and to ensure cost-effectiveness. A myriad of structure, process and outcome measures offering a multi-dimensional evaluation were chosen to make us accountable to a broad range of stakeholders, from our funders, other service providers, to our patients and their families. EPIP has shown good outcomes in terms of number of patients accepted into the programme, as well as our clinical service provision. Such outcomes are achieved with our community partners playing an important role. General Practitioners, in particular, are vital not only in the detection, management of such individuals, but also in the re-integration of our patients back to community.

Deinstitutionalization ; Hospitals, Psychiatric ; Humans ; Mental Disorders ; therapy

Most clinicians and researchers will acknowledge the importance of mentoring in their respective fields but whether what is done is truly mentoring is presumed rather than explicit. This paper explores the nature and importance of mentorship in the development of a junior faculty member, and the qualities of a good mentor and mentee. It emphasises the multi-faceted complexity of this relationship including its potential problems, and its inevitable termination. This ending might be unexpected, premature and traumatic; or it may be planned when the mentee has developed a certain level of maturity and independence of thinking and judgment. Either situation requires working through this feeling of loss.
Education, Medical, Graduate ; Faculty, Medical ; Humans ; Mentors

Employment ; Employment, Supported ; methods ; Humans ; Mental Disorders ; epidemiology ; rehabilitation ; Prejudice ; Rehabilitation, Vocational ; methods ; Return to Work ; Singapore ; epidemiology ; Social Stigma ; Unemployment ; statistics & numerical data

Science is a human activity and like all human activities, it has its share of drama and pathos. The scientific product is often an interaction of certain ways of thinking, personality traits, and circumstances. This essay examines these factors and how the melding of that could lead to breakthrough discoveries. It may in some instances, go wrong, or take a morally ambiguous path.
Creativity ; Philosophy, Medical ; Research