![]() ![]() Despite this overlap, the evidence of PTSD with comorbid psychosis as a distinct entity lies in the research showing biologic, genetic and treatment management differences between psychotic PTSD, non-psychotic PTSD and psychotic disorders. There are some overlapping symptoms of both PTSD and psychosis that make diagnosis challenging. Since the addition of PTSD into the Diagnostic and statistical manual of mental disorders-3 rd edition (DSM-III), there has been emerging evidence for a variant of PTSD involving the presence of psychosis when full PTSD criteria are met ( Association, 1980 Braakman, 2009 Hamner, M B, Frueh, Christopher, Ulmer, Helen, Huber, Michael, Twomey, Timothy, Tyson, Clare, Arana, 2000 Hamner, 1997 Hamner et al., 1999 Ivezic et al., 2000 Seedat S, Stein MB, Oosthuizen PP, Emsley RA, 2003). However, the lifetime prevalence of PTSD is approximately 7% ( Kessler, 1995 Read, 2005). The lifetime prevalence of trauma exposure found in the US community is 40–80% with an average of 3.5 different events ( Kessler, 1995 Read, 2005). ![]() ![]() Posttraumatic stress disorder (PTSD) is a nosological diagnosis characterized by the presence of trauma exposure with a minimal of one month of persistent symptoms, at least one symptom from the four clusters: intrusion, avoidance, negative mood and cognitive alterations, as well as arousal and reactivity ( Gayle and Raskin, 2017). Trauma exposure leads to various psychiatric disorders including depression, anxiety, bipolar disorders, personality disorders, psychotic disorders, and trauma related disorders, especially posttraumatic stress disorder (PTSD) ( Schäfer and Fisher, 2011a). Hence, developing an operational diagnostic criteria and treatment framework for clinical and research use is critical. There is not enough evidence to recommend second generation antipsychotics (SGA) for PTSD-SP given that risperidone and quetiapine are the only SGAs studied in randomized controlled trials. Individuals with PTSD and comorbid psychosis can benefit from evidence based psychotherapy (EBT). This review has presented evidence for individuals with PTSD-SP being distinct in genetics and neurobiological factors. There is emerging evidence that PTSD with secondary psychotic features (PTSD-SP) might be a discrete entity of PTSD with known risk factors that increase its prevalence. Despite this overlap, the evidence of PTSD with comorbid psychosis as a distinct entity lies in the research showing biologic, genetic and treatment management differences between psychotic PTSD, non-psychotic PTSD, psychotic disorders and healthy controls. Trauma exposure leads to various psychiatric disorders including depression, anxiety, bipolar disorders, personality disorders, psychotic disorders, and trauma related disorders, especially posttraumatic stress disorder (PTSD). ![]()
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