Translational and clinical research in Singapore: ethical issues in a longitudinal study of the prodromal phase of schizophrenia


Dr Tamra Lysaght, Centre for Biomedical Ethics, National University of Singapore, Dean's Office, Yong Loo Lin School of Medicine, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore 119228. Email:


Aims: This paper aims to provide an overview of the ethical issues that have been raised by The Longitudinal Youth at Risk Study, which is being led by the Institute of Mental Health in Singapore as part of a multi-centre and multinational study in translational and clinical research in psychosis. This project is designed to identify the biomarkers of the trajectory to psychosis. As well as providing insights into the psychopathology and psychophysiology of the disease, the study will prospectively identify those in the Singaporean population with an ultra-high risk of developing psychosis. The project will collect both observational and clinically relevant data from an at-risk group: adolescents and young adults.

Methods: A normative analysis was used to consider the ethical issues that arise as a result of this study, its methods, sample population and clinical management policy.

Results: The project was found to raise particular and sensitive ethical and legal issues relating to the conduct of research with vulnerable populations who may be entering the prodromal phase of psychosis. Issues raised included notions of consent, privacy, confidentiality, stigmatization, duty of care and therapeutic misconception.

Conclusion: Whereas some of the issues raised by this study present with manageable solutions, others may be justifiable within the cultural context of Singapore and warrant further discussion.