Comorbid: Posttraumatic Stress Disorder and Schizophrenia

Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications

“…It has been repeatedly found that there is considerable overlap between the diagnostic constructs of schizophrenia, dissociative disorders and PTSD (31, 33, 136). The DSM states that in PTSD the re‐experiencing of the trauma includes ‘hallucinations and dissociative flashback episodes’ (137).…”

“…For example when elevated rates of psychotic symptoms were identified in Vietnam veterans it was automatically assumed that any diagnoses of schizophrenia were misdiagnoses and that these symptoms were therefore somehow non‐psychotic (32). Recent research, however, has noted marked similarities between PTSD and schizophrenia (33). Hamner et al.…”

“…Of course, if the psychosis is itself a reaction to childhood trauma in the first place, this would position psychosis and hospitalization as mediating variables in the relationship between child abuse and negative symptoms. Another important research avenue is the overlap, and relationship, between negative symptoms and the clearly trauma‐based avoidance and numbing symptoms of PTSD (33, 129).…”

“…We have seen that hallucinations are strongly related to child abuse. Some psychotic hallucinations appear to be nothing more or less than memories of traumatic events identical to the split‐off flashbacks usually considered indicative of PTSD rather than schizophrenia (30, 33, 114, 120). As discussed earlier, hallucinations can be recategorized when trauma is identified simply because of the assumption that trauma cannot cause psychosis but can cause PTSD.…”

A prospective study of PTSD following recovery from first‐episode psychosis: The threat from persecutors, voices, and patienthood

“…It may be difficult to distinguish between hallucinations and flashbacks, both of which might contribute to ideas of reference and anomalous behaviour such as talking to oneself (Muenzenmaier et al , 2005; Rosenberg et al , 2001; Shaner & Eth, 1989). Negative symptoms, such as emotional blunting and social withdrawal, might be difficult to distinguish from trauma‐related avoidance (Muenzenmaier et al , 2005; Rosenberg et al , 2001; Shaner & Eth, 1989). Poor concentration, irritability, or hypervigilance may be interpreted as symptoms of either hyperarousal or psychosis (Shaner & Eth, 1989).…”