Prevalence of post-traumatic stress disorder in first-episode psychosis

Background: Psychosis can be considered one of the most severe stressors that an individual may face. Previous studies have suggested that the traumatic experience of psychotic symptoms and hospitalization may provoke a post-traumatic type reaction. Aim: The aim of this study was to establish the point prevalence of post-traumatic stress disorder (PTSD) among patients recovering from a first-episode of psychosis in Singapore, and to elucidate the factors associated with it. Methods: Patients from the Early Psychosis Intervention Programme in Singapore, who were recovering from their first psychotic episode, participated in this study. Diagnoses were made using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) - Text Revised Axis I Disorders. The Clinician-Administered PTSD Scale, an interviewer-rated semi-structured interview, was used to diagnose PTSD. Results: Sixty-one patients (30 males, 31 females) were recruited. Twelve (19.7%) patients were diagnosed with PTSD. Hospitalization for treatment, whether compulsory or otherwise, did not increase the rate of PTSD. The Chinese ethnic group had lower risk of developing PTSD (adjusted odds ratio 0.14, P = 0.018). Conclusions: There was a high prevalence of PTSD in patients recovering from their first psychotic episode. This study raises awareness among clinicians and hopes to promote early recognition and treatment of PTSD so as to potentially improve outcome.