Does a Study Focused on Trauma Encourage Patients With Psychotic Symptoms to Seek Treatment?

Objective: This study explored, in a randomized trial of psychotherapies for posttraumatic stress disorder (PTSD), why a surprisingly high percentage of study applicants presented with psychotic symptoms and what clinical implications this finding might prompt. Methods: Raters reviewed the records of applicants who completed an initial psychiatric interview and compared those who had psychotic symptoms with all other study-eligible participants and with those who ultimately were enrolled in the study. Results: Of 223 consecutively evaluated individuals who applied for study entry, 38 (17%) were found ineligible because of psychotic symptoms. These individuals were more likely to be male and to have suffered child abuse, and they had taken a greater number of lifetime medications than study-eligible applicants. Most individuals with psychotic symptoms met DSM-IV criteria for PTSD. Conclusions: A trauma-informed framework might be a helpful part of a comprehensive treatment plan for some individuals with psychotic symptoms, possibly leading to greater treatment engagement and more positive outcomes. (Psychiatric Services 63:386-389, 2012; doi: 10.1176/appi.ps.201100251)