In my medical career, I often encounter patients’ families asking me questions like: Is my family member seriously ill? Why does he/she have such a disease? Is it caused by disharmony in interpersonal relationships? Psychiatric patients with their first episode can more or less identify some psychosocial factors, such as the patient having problems with teachers or classmates at school, or with superiors or colleagues at work, or even having arguments and physical contact. However, usually these factors do not have a significant impact on normal people. Are these social factors really the direct cause of psychiatric illness? The occurrence of psychosis, except for mental disorders caused by brain somatic diseases, psychoactive substances, etc., can identify specific causes, but it is difficult for us to identify the causes of severe psychosis, such as schizophrenia, mania, major depression, etc., and medical scientists clearly point out that the occurrence of these diseases is caused by the aggregate effect of multiple factors and individual susceptibility. Sometimes psychosis can occur after an unusual life event or after suffering a psychological trauma. A significant proportion of patients go through a considerable period of time from early symptoms to the onset of clinical psychotic symptoms. This period, which psychiatry calls the prodromal or disease development phase, is the period when the patient retains some social functioning and continues to perform his/her social role tasks, but their interpersonal relationships become strained or discordant or diluted. It is only when they reach the disease stage – when obvious clinical symptoms appear, such as hallucinations and delusional symptoms – that their social functioning – ability to learn or work, ability to take care of themselves, interpersonal skills, etc. – is seriously affected, and they are taken seriously by the people around them, who suspect that he/she is not really ill. Generally speaking, during the weeks to months before the onset or relapse of psychosis, the patient will experience insomnia, irritability, anxiety, paranoia, social withdrawal, detachment from usual habits, and a gradual qualitative change in life trajectory. Patients with schizophrenia can experience interpersonal tension, distant relationships with friends and relatives, lazy living, lack of delicate emotions, insomnia, anxiety and nervousness, sensitivity and paranoia, and even depression and irritability in the early stage; patients with depression often complain of numerous physical discomforts, show incompetence, lose interest in many things that originally interested them, have decreased appetite and libido, have low self-esteem, are reluctant to interact, and avoid social interaction. Patients with mania, however, show high energy, inflated self-confidence, excessive enthusiasm and generosity to people, or easy to lose temper, etc. Case: Patient, male, 22 years old, senior in college. Since school, academic performance has been excellent, but from the second semester of sophomore year onwards began to become withdrawn, bad interaction and do not get along, like to be alone, and family contact becomes less and less, inattentive, academic performance gradually declined, often unexplained absences, failing more and more homework, to the first half of the fourth semester suddenly called his family, saying that people in the same dormitory are bullying him, and later repeatedly called his family He said that many students were bad-mouthing him and that he felt that there were always people talking about him behind his back, that his whereabouts were always being watched, that his thoughts were somehow known, that he had no privacy left, and that he was nervous and scared. The family believed it was true and went to school to find out what was going on, but it was not. They thought the patient was depressed and took him to a specialist hospital, but he was diagnosed with schizophrenia. Then they took the patient to several other specialist hospitals, and the diagnosis was more or less the same. Finally, the family had to resign themselves to their fate and sent the patient to a psychiatric hospital for inpatient treatment. After a period of systematic and regular treatment, the patient soon recovered and was discharged from the hospital, and graduated from the exams and completed his education. The above case shows that the patient’s psychiatric symptoms developed over a long period of time and were only treated after social functioning was significantly impaired. In addition, it also shows that as long as mental illness is detected early and treated early, there is still hope for a cure in the end, and it is not terrible to have mental illness, what is terrible is to avoid treatment! In patients in the prodromal phase, they can experience interpersonal tension and even depression. It can be said that a significant proportion of psychiatric patients have interpersonal tension and sensitivity and paranoia as a result of their illness, rather than psychosis caused by interpersonal tension. With careful observation or review of medical history, it is not difficult to find this phenomenon. Of course, the occurrence of interpersonal disharmony in actual life or work can also easily trigger the occurrence or recurrence of psychosis, but it is not necessarily the direct cause.