Schizophrenia & delusional disorders

Schizophrenia and delusional disorders are psychotic disorders where the sufferer loses touch with reality.

Schizophrenia is a serious mental illness which affects around 1% of the population. Sufferers may have abnormal experiences such as hallucinations – hearing and seeing things which are not real. They may develop abnormal paranoid beliefs for example that they are being watched, spied upon, and persecuted. Their thoughts and behaviours may become disorganized such that they can no longer function in school, work and in the family.
  • Auditory hallucinations – hearing voices which do not exist
  • Other types of sensory disturbances such as abnormal visions, smells, taste and sensations on the skin
  • Delusions – abnormal beliefs which are not in keeping with the person’s cultural and social background. These beliefs may come in many different forms.
  • Disorganized thought process – no longer able to think clearly, resulting in speech which is difficult to understand
  • Disorganized behaviours which are not usually normal for the sufferer. Rarely these behaviours can be dangerous and pose a risk to the person himself or others around him.
Risk factors:
  • A family history of psychotic disorders
  • Pregnancy and birth complications which have affected development of the brain eg. Exposure to toxins or having a brain infection at a very young age
  • Certain genetic conditions
  • Exposure to psychoactive substances such as brain stimulants or hallucinogens
Types of schizophrenia
  • Paranoid Schizophrenia
  • Hebephrenic Schizophrenia
  • Catatonic Schizophrenia
  • Simple Schizophrenia
  • Undifferentiated Schizophrenia
Delusional disorders may be of the following types, classified according to the content of the delusions:
  • Persecutory 
  • Grandiose 
  • Somatic 
  • Jealous 
  • Erotomanic 
  • Mixed
  • Unspecified
  • Anti-psychotic medications 
  • Sedative medications to help manage strong emotions, restlessness, risky behaviours and promote sleep
  • Long-acting injectable antipsychotic medications
  • Psychosocial interventions such as individual therapy, family interventions, vocational rehabilitation and supported employment.


Although considered one of the more serious mental disorders, schizophrenia is highly responsive to medications. Majority of patients see significant improvement on anti-psychotic medications. Most patients will require medications for several years. Stopping medications prematurely leads to an increased risk of relapse.

In our clinical practice, we have seen persons with schizophrenia achieve full remission and lead normal, productive and fulfilling lives. You may have heard of Elyn Saks, a highly accomplished American Professor of Law, Psychology and Psychiatry, and who suffers from schizophrenia. In Singapore, many persons with schizophrenia continue to have a good quality of life. The key is to seek treatment early, so that early milder symptoms can be reversed, and complications such as cognitive impairment can be averted.

If you suspect that you or a loved one is suffering from a psychotic disorder such as schizophrenia, do not hesitate to seek help early.