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LOW RATE HOSPITAL ADMISSION FOR SCHIZOPHRENIA PATIENTS AFTER A YEAR IN COMMUNITY PSYCHIATRIC AND REHAB SERVICE 

DEC 14, 2018 @8.25 PM
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People with schizophrenia often experience fear, confusion and paranoia.
​Schizophrenia is a highly debilitating disease that appears in late adolescence or early adulthood. Characterized by delusions, hallucinations and other cognitive difficulties, it can be a lifelong struggle.

In Malaysia, the total estimated number of treated schizophrenia cases in 2015 was 15,104 (The economic burden of schizophrenia in Malaysia, 2017). 

Symptoms
Dr Michael Ang Jin Kiat, senior lecturer at the Faculty of Medicine & Allied Health Sciences, Universiti Putra Malaysia explained that the symptoms of schizophrenia include positive, negative and disorganised symptoms. 

“Positive symptoms refer to the presence of psychotic behaviours not seen in healthy people. People with positive symptoms often "lose touch" with reality. These symptoms can come and go. Sometimes they are severe and at other times hardly noticeable, depending on whether the individual is receiving treatment.”
​
Positive symptoms include hallucinations —a sensory perception in the absence of stimuli— may be disrupted by other features arising from external space which cannot be stopped at will, arises in clear conscious and possess the quality of a real percept. 

Michael disclosed that delusions is another positive symptom where the patient might believe that there are people out there who are trying to harm him/her, or they may believe that they're on top of the world, is the riches person or he received a special message from god so he needs to carry out certain missions. The illness transmits all these information into the brain, and their brain tells them that it’s true. To him it’s very true – to us it isn't.” 

Negative symptoms include neglecting self-care, isolating oneself at home and not wanting to leave, staying in bed almost all day and not wanting to do anything. They may also suffer mood swings whereby they can become sad, happy and irritable which disrupts their life. 

Treatment
Apart from the usage of antipsychotic medications, A Review of Schizophrenia Research in Malaysia (2014) claimed that hospital-based community psychiatric and rehabilitation service found that 90 per cent of schizophrenia patients had low rate of hospital admission within one year of being enrolled in this service. 

The study also revealed that community based patients were significantly less depressed, and had higher functional capability than chronic schizophrenia inpatients. 

However, it remains unclear if the community psychiatric and rehabilitation services used targeted cognitive training (TCT) - a promising therapeutic intervention that had emerged of late. 

TCT uses computerised training, such as sophisticated brain games, to target specific neural pathways, such as memory, learning and auditory-based senses to beneficially alter the way schizophrenia patients process information.

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