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Tan Yi Hui
Tue, Jun 03, 2008
The Straits Times
Stressing on schizophrenia

Mother-of-three Rita Goh used to believe there was a microchip embedded in one of her teeth, and that she was communicating with someone through it.

Bizarre behaviour and hallucinations such as this prompted her husband, businessman Vincent Loy, 56, to seek medical help, and she was diagnosed with a mental disorder known as schizophrenia.

That was four years ago. After a year of treatment, Ms Goh, 51, has recovered enough to set up her own private counselling centre, Aspiron Services, to help others like her.

The illness was in the headlines last week when The Straits Times reported that a jobless man killed his uncle by stabbing him repeatedly in the mistaken belief the latter was responsible for the deaths of his elder brother and grandfather.

Heng Boon Chai, 30, admitted to manslaughter. The charge was reduced from murder as he was diagnosed to be suffering from paranoid schizophrenia, which reduced his responsibility for the killing. Sentencing will follow pending more psychiatric evidence.

Also this month, a mega-research project here was given $25 million to tackle the crippling condition.

Schizophrenia is ranked ninth, together with breast cancer, in terms of disease burden here - a measure that combines years of life lost through premature death and disability - but it is a mysterious disease to some, and many mistaken beliefs have arisen about it.

Sufferers exhibit delusions and hallucinations, and can seem to lose touch with reality. As a result, they may also suffer anxiety and depression, and their attention span and memory may deteriorate if left untreated.

As for Ms Goh, she says: 'I was very determined not to let the illness take over my life.' She is now off anti-psychotic drugs, but still takes a daily antidepressant pill.

Schizophrenia affects about one in 100 here. Cases total about 2,000 to 4,000 annually. The Institute of Mental Health (IMH) alone says it receives about 200 new cases a year.

Experts say two-thirds of cases are hereditary, while the rest may be a result of factors such as brain damage at birth, or in the womb.

Many people fear that sufferers can turn violent, as in the case of the man who stabbed his uncle.

But psychiatrist Dr Ken Ung from regional healthcare group Pacific Healthcare says: 'Of the hundreds of patients I have seen, only about a dozen acted in violence because of their condition.'

The risk of violence can be aggravated by alcohol or drug abuse. But a much greater risk is that the sufferer will commit suicide, with about 10 to 20 per cent of patients eventually taking their own lives, says Dr Ung.

And Dr Terence Leong from the Department of Psychological Medicine at the National University Hospital (NUH), points out that people with schizophrenia are in fact more likely to become victims of violence, because they may be seen as social misfits.

The age group most prone to the disorder is the 15- to 30-year-old bracket.

The recently announced $25-million study will screen people in that group to determine risk factors to see how best to delay, or even prevent symptoms, says Dr Swapna Verma, chief of IMH's Early Psychosis Intervention Programme (EPIP).

Treatment is a combination of anti-psychotic drugs and counselling, but Dr Swapna adds: 'The patient has to be engaged in treatment. Sometimes, it's not easy to get them to trust you and come for visits regularly.'

The IMH says that more patients are convinced now, and the default rate for treatment has dropped from 70-80 per cent to as low as 20 per cent.

'There might not be a cure, but if they continue their medication, they can remain in remission indefinitely,' says Dr Swapna.

Some people such as full-time tutor Harris Ng, 60, have shared their own experiences to help others and raise public awareness and acceptance of the disease.

He endured 15 years and four hospitalisations before medication and counselling worked for him.

Mr Ng, who is married, has written a book on his experiences, titled Grace: Schizophrenia.

He also gives talks and is involved in patient focus groups. He is an avid volunteer in movements such as Silver Ribbon and in organisations such as the Singapore Association For Mental Health.

Counsellors and people such as Mr Ng acknowledge that while the public is gradually learning to accept victims of mental illnesses, the social stigma, making it hard to re-integrate into society, remains.

He says: 'When people see someone such as me who has gone through this, they will know that recovery is possible.

'They won't think we are weird or have to be locked up.'

 

 
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