New York State Psychiatric Institute researchers studying psychotherapies for posttraumatic stress disorder (PTSD) were surprised to find that 17 percent of applicants to the study had psychotic symptoms such as paranoia, delusions, auditory and visual hallucinations, and thought disorder. This suggests that offering trauma-focused therapy may be a way to reach people with psychotic symptoms, who often avoid psychiatric treatment.
During screening, explained senior author John C. Markowitz, MD, who is also in Columbia’s Department of Psychiatry, these applicants often minimized their psychotic symptoms while discussing psychosis; they believed their psychotic symptoms to be those of trauma. Most had in fact experienced trauma and appeared to have PTSD.
The researchers concluded that their NIMH-funded study appealed to individuals with psychotic symptoms both because it offered treatment other than medication (none was taking medication) and because there is less stigma attached to PTSD than to psychotic disorders. These individuals may think of trauma as external but psychosis as internal, and thus a character flaw.
“Does a Study Focused on Trauma Encourage Patients With Psychotic Symptoms to Seek Treatment?” appears in the April 2012 issue of Psychiatric Services.