Psychotic Symptoms in Combat-Related Post-Traumatic Stress Disorder

Abstract

The presence of psychotic symptoms in post-traumatic stress disorder (PTSD) has already been recognized. Using the Structured Clinical Interview Diagnostic and Statistical Manual, we searched for and assessed psychotic symptoms in 91 males suffering from combat-related PTSD. Hallucinations and delusions were present in 20% of patients. We divided all patients into three groups: the group with hallucinations and delusions, the group without these symptoms, and the group with "subthreshold" psychotic symptoms. Using the Harvard Trauma Questionnaire, Clinician-Administered PTSD Scale, and Structured Clinical Interview Diagnostic and Statistical Manual, we investigated differences between groups in the intensity of traumatization, severity of PTSD symptoms, and the frequency of depression. There were no significant differences between groups; however, there was one exception: severity of hyperarousal symptoms was positively correlated with occurrence of psychotic symptoms.

Psychotic depression, posttraumatic stress disorder, and engagement in cognitive-behavioral therapy within an outpatient sample of adults with serious mental illness

“…First, it is possible that exposure to higher levels of trauma reflect cumulative stress that could increase vulnerability to psychotic symptoms, consistent with epidemiological surveys linking trauma exposure with psychotic symptoms (60), and consistent with the stress-vulnerability hypothesis. Second, severe hyperarousal symptoms in PTSD may provoke psychotic symptoms in persons with primary PTSD but not severe mental illness, as reported in several studies of PTSD and psychotic symptoms (61, 62). Third, psychotic symptoms may lead to increased arousal.…”

Associations between use of cocaine, amphetamines, or psychedelics and psychotic symptoms in a community sample

“…As it is well known that psychotic symptoms may be present in the context of a mood disorder, for example, major depressive episode with psychotic features or manic episode with psychotic features, and psychotic symptoms may also occur in the context of an anxiety disorder, for example, in Post-Traumatic Stress Disorder (48,49), a subgroup analysis where all participants with a mood or anxiety disorder were excluded was performed in the same manner as described earlier. Table 1 provides the cumulative lifetime incidence estimates of cocaine, amphetamine, or psychedelic use in the EDSP sample until the 10-year followup.…”

Bupropion-Related Visual Hallucinations in a Veteran With Posttraumatic Stress Disorder and Multiple Sclerosis

“…Psychotic symptoms such as visual or auditory hallucinations are common among patients with PTSD with the prevalence up to 64%. 13,14 However, this veteran did not have any visual hallucinations before receiving bupropion. Bupropion has been used for treatment of veterans with PTSD 15 and has also been used for smoking cessation 16 previously, but no hallucinations have been reported as an adverse effect.…”