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Study aims to define risk factors, help doctors detect condition early
A YOUNG person prone to psychosis needs help – or he could become permanently schizophrenic. Experts have found that psychosis leading to schizophrenia is most likely to start between the ages of 15 and 29, if unarrested. Conversely, early detection and treatment of the condition can lead to a full recovery. With the aim of better dealing with psychosis – a condition that makes sufferers see or hear things that are not really there – the research division of the Institute of Mental Health (IMH) began a five-year study of people in that age group.
It is one of the five translational and clinical research programmes that each received $25 million from the National Research Foundation to “translate” findings into applications or treatments. The large-scale initiative, into its sixth month, currently involves more than 500 people, and will look at factors that trigger the mental condition. When the Longitudinal Youth-At-Risk Study, or Lyriks, is completed, it should more clearly define risk factors for psychosis – be they irregularities in the blood, unusual brain activity or environmental influences such as family or schoolmates.
The study’s participants will be monitored for two years at six-month intervals. They will be interviewed about their physical and emotional states, and take tests to gauge their levels of concentration, logic and recall. Some may also give blood samples or undergo magnetic resonance imaging (MRI) brain scans. Such tests will shed light on the little known condition, by allowing researchers to observe differences between normal and at-risk subjects. These differences can then be measured scientifically, said Associate Professor Chong Siow Ann, the principal investigator for the study. Researchers hope to use their findings to develop a checklist or diagnostic process to help doctors, similar to their looking at indicators like blocked arteries or high cholesterol levels for heart disease. The process, Prof Chong hopes, will enable people to deal with symptoms earlier, and lower their risk for psychosis.
Prof Chong, who is also the vice-chairman of the medical board of research at the hospital, said that if through the study, IMH identifies young subjects with developing symptoms, it will also reach out to them and refer them to a psychiatrist for counselling and treatment. So far, more than 1,430 people have signed up to be surveyed through roadshows, online forums and friends. Of that number, those who are not at risk – 457 people – are part of a control group. Another 147 have been found to be at risk of psychosis, with 75 of them agreeing to be study participants. Prof Chong needs more recruits. He wants to identify up to 1,000 people who are at risk to ensure that the study is statistically robust.
Undergraduate Moses Lee, 24, volunteered to be screened when he learnt about the Lyriks study at a roadshow. A few years ago, he had a friend who had suicidal thoughts, and her misery was infectious, he told The Straits Times. “It’s quite depressing for me when people tell me about their troubles and I can’t help them. Worse, there’s this depressed energy around them and you feel bad too,” he said. He wanted to be screened to learn more about mental conditions and to help, if possible.
Miss A.D. Tan, 21, who is enrolled in a private school, was recruited as a participant after getting a regular check-up from her doctor six months ago. She felt the survey was especially necessary in Singapore, where young people like her face stress to perform well academically, and in their relationships. At least for one test subject, a 29-year-old information technology engineer who wished to be identified only as Mr Chan, the process has been interesting. Once, he was shown pictures of women and had to rate which he found prettier by clicking a remote control. He did this lying inside the MRI machine as it captured pictures of his brain, a session he called “quite fun”.
Early warning signs
ASSOCIATE Professor Chong Siow Ann says the onset of psychosis can be quite “insidious” and “not obvious at all”. But here’s how you can tell if someone is exhibiting early signs of psychosis:
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Their memory starts becoming patchy.
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They may have difficulty sustaining concentration.
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They may seem depressed or anxious.
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They may start to withdraw from people.
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They may drop out of school.
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Their senses may start getting distorted, for instance, they may hear voices telling them to hurt themselves.
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