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Examining the relationship between trauma, post-traumatic stress disorder and psychosis in patients in a UK secondary care service

Martin, Dave, Philips, Michelle, Strelchuk, Daniela, Greenstone, Harriet, Davies, Jonathan, Stewart, Guy, Ewin, Elizabeth and Zammit, Stan ORCID: 2023. Examining the relationship between trauma, post-traumatic stress disorder and psychosis in patients in a UK secondary care service. Psychiatric Research and Clinical Practice 5 (2) , pp. 51-59. 10.1176/appi.prcp.20220028

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Objective Traumatic experiences and post-traumatic stress disorder (PTSD) are common in schizophrenia. However, few studies screening for PTSD have established the temporality of PTSD-related traumatic events to psychosis onset. Furthermore, it is unclear how many patients attribute a trauma-based contribution to their psychosis or would find trauma-focused therapy acceptable. We examine the prevalence and timing of trauma in psychosis, as well as patient views on the relationship between their trauma experiences and mental health difficulties, and on receiving trauma-focused therapy. Methods Sixty-eight patients with an at-risk mental state (ARMS) or psychotic disorder in a UK secondary-care setting completed self-report measures of trauma and PTSD, and undertook research interviews. Proportions and odds ratios were derived with 95% confidence intervals. Results We recruited 68 participants (estimated response rate 62%; psychotic disorder n = 61, ARMS n = 7). Sixty three (95%) reported traumatic events and 32 (47%) reported childhood abuse. Twenty-six individuals (38%) met criteria for PTSD, though for >95% this was not recorded in their notes, and 25 (37%) had sub-threshold PTSD. For 69% of participants, their worst trauma occurred before the onset of their psychosis symptoms. Most (65%) believed their psychosis symptoms were related to past traumas and 82% of these were interested in receiving trauma-focused therapy. Conclusions PTSD is common in and often pre-dates onset of psychosis. Most patients believe their symptoms and traumas are related and would be interested in trauma-focused therapy if available. Studies evaluating the effectiveness of trauma-focused therapies for those with or at high-risk of psychosis are required.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG)
Publisher: Wiley
ISSN: 2575-5609
Date of First Compliant Deposit: 21 December 2022
Date of Acceptance: 15 December 2022
Last Modified: 12 Jan 2024 14:06

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