Table of ContentsView AllTable of ContentsUnderstanding the ConnectionComplicationsDiagnosisTreatmentCoping

Table of ContentsView All

View All

Table of Contents

Understanding the Connection

Complications

Diagnosis

Treatment

Coping

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Post-traumatic stress disorder(PTSD) is a condition that can occur after someone has experienced a traumatic event. It involves four clusters of symptoms:re-experiencingsymptoms, avoidance symptoms, negative changes in mood and brain function, andhyperarousal symptoms.

However, sometimes PTSD can also occur with psychosis.Psychosisinvolves losing connection with reality, which can lead to symptoms such as delusions, hallucinations, and incoherent behavior. One study suggested that around 2.5% of people with PTSD also have psychosis.

This article discusses the connection between PTSD and psychosis and how having both conditions can affect diagnosis and treatment.

The Connection Between PTSD and Psychosis

Psychotic symptoms might be related to the severity of an individual’s PTSD symptoms. The more PTSD symptoms you’re experiencing, the greater the likelihood you will also have psychosis.

It has been suggested that dissociation that occurs in PTSD may explain co-occurring psychosis. Frequent dissociation may increase a person’s risk of developing psychotic symptoms.

While PTSD and psychosis are separate conditions, research suggests that there is evidence that PTSD with secondary psychotic features (PTSD-SP) might be a distinct form of PTSD.

Traumatic eventsthat increase the risk of develop PTSD with psychosis include:

Other risk factors that can increase the likelihood of psychosis include schizophrenia, other mental disorders, physical illness, and substance use.

Flashbacks and Dissociation in PTSD

Complications of PTSD and Psychosis

When people have PTSD with psychosis, they can experience different types of psychotic symptoms alongside other symptoms of PTSD. This can include having positive and negative psychotic symptoms, flashbacks, and dissociation. This can complicate both the diagnosis and treatment process.

Psychosis-Related PTSDResearch has also shown that experiencing psychosis is traumatic, which can lead to psychosis-related PTSD. One systematic review found that 14% and 47% of people with psychosis develop this type of PTSD.

Research has also shown that experiencing psychosis is traumatic, which can lead to psychosis-related PTSD. One systematic review found that 14% and 47% of people with psychosis develop this type of PTSD.

People with PTSD who experience psychotic symptoms, as compared to those with PTSD who do not, might be at greater risk for several mental health concerns, includingsuicidal thoughts, suicide attempts, and more significant overall distress. It’s essential for everyone with PTSD and their loved ones to know therisk factors and warning signs of suicide.

If you experience psychotic symptoms such as delusions, disorganized thinking, hallucinations, or flat affect, you should consult a medical professional immediately. You should also seek help immediately if you experience suicidal thoughts or behaviors.

If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

Diagnosis of PTSD and Psychosis

To diagnose PTSD with psychosis, doctors will evaluate an individual’s symptoms, perform physical and lab tests to rule out other conditions, and review the individual’s medical history. This allows them to assess symptoms of PTSD and psychosis.

Flashbacks and dissociation commonly occur with PTSD. While they are not psychotic symptoms, they share some features with psychosis, including:

Psychosis Symptoms

To make a diagnosis, a doctor will also note the presence of psychotic symptoms.Psychotic symptomscan be divided into two groups: positive symptoms and negative symptoms. However, this doesn’t mean some psychotic symptoms are good and some are bad.

Positive symptoms refer to an experience, such as hallucinations, while negative symptoms refer to the inability to show emotions, apathy, difficulties talking, and withdrawing from social situations and relationships.

In addition to PTSD, positive and negative psychotic symptoms can occur in other mental health conditions. It can sometimes be difficult to distinguish between them, as the symptoms can overlap.

Mental health conditions that can have positive and negative psychotic symptoms include:

Some peoplehave both schizophrenia and PTSD. Research has shown that traumatic experiences are more common among people withschizophreniathan in the general population. A 2018 study found a significant genetic overlap between schizophrenia and PTSD.

RecapPTSD and psychosis have overlapping symptoms that can make diagnosis more challenging. Doctors will evaluate symptoms, including flashbacks, dissociation, and psychosis, to make a diagnosis. They also have to rule out other conditions that feature psychotic symptoms. Some people may experience PTSD and other conditions such as schizophrenia.

Recap

PTSD and psychosis have overlapping symptoms that can make diagnosis more challenging. Doctors will evaluate symptoms, including flashbacks, dissociation, and psychosis, to make a diagnosis. They also have to rule out other conditions that feature psychotic symptoms. Some people may experience PTSD and other conditions such as schizophrenia.

Treatment of PTSD and Psychosis

If you or a loved one who has PTSD is experiencing psychotic symptoms, it’s essential to seek out treatment. Treatment can not only improve functioning, it can reduce the risk of developing psychotic symptoms linked to untreated PTSD.Treatment options include:

Treatment is also essential if a person has co-occurring PTSD and schizophrenia. However, having both disorders can complicate the treatment process. For example,exposure therapy for PTSDmay not be the best treatment for someone with schizophrenia, as it could worsen their symptoms.

Studies have found that well-thought-out treatment can reduce the symptoms of PTSD. For those with PTSD and schizophrenia, finding a mental health provider who is familiar with treating both conditions is important.

Coping With PTSD and Psychosis

For people who are experiencing symptoms of PTSD and/or psychosis, getting treatment is essential. In addition to seeking help from a qualified professional, people can also utilize strategies to cope:

The experience of psychotic symptoms may tell the story of how severe a person’s PTSD is and how well they are coping with it. If symptoms are severe or worsening, it is essential to talk to your doctor.

Summary

Some symptoms of PTSD share common features with psychosis, but it is also possible to experience psychosis along with PTSD. Experiencing symptoms of severe PTSD can elevate this risk. Possible complications of having both conditions include an increased risk of depression, self-harm, and suicidal behavior.

Treatment is essential and may involve psychotherapy, medication, or a combination. Caring for yourself, finding support, and being aware of PTSD triggers can be helpful when managing symptoms of both conditions.

A Word From Verywell

Trauma can have profound and lasting effects, including the onset of post-traumatic stress disorder. While psychosis is not a typical symptom, it can occur in people with PTSD. If you are experiencing symptoms of PTSD, getting treatment may help reduce the risk of psychosis. Talk to your doctor for further evaluation and treatment recommendations.

If you or a loved one are struggling with PTSD or psychosis, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.For more mental health resources, see ourNational Helpline Database.

If you or a loved one are struggling with PTSD or psychosis, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.

For more mental health resources, see ourNational Helpline Database.

10 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Miao XR, Chen QB, Wei K, Tao KM, Lu ZJ.Posttraumatic stress disorder: from diagnosis to prevention.Mil Med Res. 2018;5(1):32. Published 2018 Sep 28. doi:10.1186/s40779-018-0179-0Hamner MB.Psychotic symptoms in posttraumatic stress disorder.FOC. 2011;9(3):278-285.Buswell G, Haime Z, Lloyd-Evans B, Billings J.A systematic review of PTSD to the experience of psychosis: prevalence and associated factors.BMC Psychiatry. 2021;21(1):9. doi:10.1186/s12888-020-02999-xGibson LE, Alloy LB, Ellman LM.Trauma and the psychosis spectrum: A review of symptom specificity and explanatory mechanisms.Clin Psychol Rev. 2016;49:92–105. doi:10.1016/j.cpr.2016.08.003Compean E, Hamner M.Posttraumatic stress disorder with secondary psychotic features (PTSD-SP): Diagnostic and treatment challenges.Prog Neuropsychopharmacol Biol Psychiatry. 2019;88:265-275. doi:10.1016/j.pnpbp.2018.08.001Şar V.The many faces of dissociation: opportunities for innovative research in psychiatry.Clin Psychopharmacol Neurosci. 2014;12(3):171–179. doi:10.9758/cpn.2014.12.3.171Gaebel W, Zielasek J.Focus on psychosis.Dialogues Clin Neurosci. 2015;17(1):9–18.Lyne J, O’donoghue B, Roche E, Renwick L, Cannon M, Clarke M.Negative symptoms of psychosis: a life course approach and implications for prevention and treatment.Early Interv Psychiatry.2018;12(4):561-571. doi: 10.1111/eip.12501Duncan LE, Ratanatharathorn A, Aiello AE, et al.Largest GWAS of PTSD (N=20 070) yields genetic overlap with schizophrenia and sex differences inheritability.Mol Psychiatry. 2018;23(3):666–673. doi:10.1038/mp.2017.77Oconghaile A, Delisi LE.Distinguishing schizophrenia from posttraumatic stress disorder with psychosis.Curr Opin Psychiatry. 2015;28(3):249-55. doi:10.1097/YCO.0000000000000158

10 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Miao XR, Chen QB, Wei K, Tao KM, Lu ZJ.Posttraumatic stress disorder: from diagnosis to prevention.Mil Med Res. 2018;5(1):32. Published 2018 Sep 28. doi:10.1186/s40779-018-0179-0Hamner MB.Psychotic symptoms in posttraumatic stress disorder.FOC. 2011;9(3):278-285.Buswell G, Haime Z, Lloyd-Evans B, Billings J.A systematic review of PTSD to the experience of psychosis: prevalence and associated factors.BMC Psychiatry. 2021;21(1):9. doi:10.1186/s12888-020-02999-xGibson LE, Alloy LB, Ellman LM.Trauma and the psychosis spectrum: A review of symptom specificity and explanatory mechanisms.Clin Psychol Rev. 2016;49:92–105. doi:10.1016/j.cpr.2016.08.003Compean E, Hamner M.Posttraumatic stress disorder with secondary psychotic features (PTSD-SP): Diagnostic and treatment challenges.Prog Neuropsychopharmacol Biol Psychiatry. 2019;88:265-275. doi:10.1016/j.pnpbp.2018.08.001Şar V.The many faces of dissociation: opportunities for innovative research in psychiatry.Clin Psychopharmacol Neurosci. 2014;12(3):171–179. doi:10.9758/cpn.2014.12.3.171Gaebel W, Zielasek J.Focus on psychosis.Dialogues Clin Neurosci. 2015;17(1):9–18.Lyne J, O’donoghue B, Roche E, Renwick L, Cannon M, Clarke M.Negative symptoms of psychosis: a life course approach and implications for prevention and treatment.Early Interv Psychiatry.2018;12(4):561-571. doi: 10.1111/eip.12501Duncan LE, Ratanatharathorn A, Aiello AE, et al.Largest GWAS of PTSD (N=20 070) yields genetic overlap with schizophrenia and sex differences inheritability.Mol Psychiatry. 2018;23(3):666–673. doi:10.1038/mp.2017.77Oconghaile A, Delisi LE.Distinguishing schizophrenia from posttraumatic stress disorder with psychosis.Curr Opin Psychiatry. 2015;28(3):249-55. doi:10.1097/YCO.0000000000000158

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Miao XR, Chen QB, Wei K, Tao KM, Lu ZJ.Posttraumatic stress disorder: from diagnosis to prevention.Mil Med Res. 2018;5(1):32. Published 2018 Sep 28. doi:10.1186/s40779-018-0179-0Hamner MB.Psychotic symptoms in posttraumatic stress disorder.FOC. 2011;9(3):278-285.Buswell G, Haime Z, Lloyd-Evans B, Billings J.A systematic review of PTSD to the experience of psychosis: prevalence and associated factors.BMC Psychiatry. 2021;21(1):9. doi:10.1186/s12888-020-02999-xGibson LE, Alloy LB, Ellman LM.Trauma and the psychosis spectrum: A review of symptom specificity and explanatory mechanisms.Clin Psychol Rev. 2016;49:92–105. doi:10.1016/j.cpr.2016.08.003Compean E, Hamner M.Posttraumatic stress disorder with secondary psychotic features (PTSD-SP): Diagnostic and treatment challenges.Prog Neuropsychopharmacol Biol Psychiatry. 2019;88:265-275. doi:10.1016/j.pnpbp.2018.08.001Şar V.The many faces of dissociation: opportunities for innovative research in psychiatry.Clin Psychopharmacol Neurosci. 2014;12(3):171–179. doi:10.9758/cpn.2014.12.3.171Gaebel W, Zielasek J.Focus on psychosis.Dialogues Clin Neurosci. 2015;17(1):9–18.Lyne J, O’donoghue B, Roche E, Renwick L, Cannon M, Clarke M.Negative symptoms of psychosis: a life course approach and implications for prevention and treatment.Early Interv Psychiatry.2018;12(4):561-571. doi: 10.1111/eip.12501Duncan LE, Ratanatharathorn A, Aiello AE, et al.Largest GWAS of PTSD (N=20 070) yields genetic overlap with schizophrenia and sex differences inheritability.Mol Psychiatry. 2018;23(3):666–673. doi:10.1038/mp.2017.77Oconghaile A, Delisi LE.Distinguishing schizophrenia from posttraumatic stress disorder with psychosis.Curr Opin Psychiatry. 2015;28(3):249-55. doi:10.1097/YCO.0000000000000158

Miao XR, Chen QB, Wei K, Tao KM, Lu ZJ.Posttraumatic stress disorder: from diagnosis to prevention.Mil Med Res. 2018;5(1):32. Published 2018 Sep 28. doi:10.1186/s40779-018-0179-0

Hamner MB.Psychotic symptoms in posttraumatic stress disorder.FOC. 2011;9(3):278-285.

Buswell G, Haime Z, Lloyd-Evans B, Billings J.A systematic review of PTSD to the experience of psychosis: prevalence and associated factors.BMC Psychiatry. 2021;21(1):9. doi:10.1186/s12888-020-02999-x

Gibson LE, Alloy LB, Ellman LM.Trauma and the psychosis spectrum: A review of symptom specificity and explanatory mechanisms.Clin Psychol Rev. 2016;49:92–105. doi:10.1016/j.cpr.2016.08.003

Compean E, Hamner M.Posttraumatic stress disorder with secondary psychotic features (PTSD-SP): Diagnostic and treatment challenges.Prog Neuropsychopharmacol Biol Psychiatry. 2019;88:265-275. doi:10.1016/j.pnpbp.2018.08.001

Şar V.The many faces of dissociation: opportunities for innovative research in psychiatry.Clin Psychopharmacol Neurosci. 2014;12(3):171–179. doi:10.9758/cpn.2014.12.3.171

Gaebel W, Zielasek J.Focus on psychosis.Dialogues Clin Neurosci. 2015;17(1):9–18.

Lyne J, O’donoghue B, Roche E, Renwick L, Cannon M, Clarke M.Negative symptoms of psychosis: a life course approach and implications for prevention and treatment.Early Interv Psychiatry.2018;12(4):561-571. doi: 10.1111/eip.12501

Duncan LE, Ratanatharathorn A, Aiello AE, et al.Largest GWAS of PTSD (N=20 070) yields genetic overlap with schizophrenia and sex differences inheritability.Mol Psychiatry. 2018;23(3):666–673. doi:10.1038/mp.2017.77

Oconghaile A, Delisi LE.Distinguishing schizophrenia from posttraumatic stress disorder with psychosis.Curr Opin Psychiatry. 2015;28(3):249-55. doi:10.1097/YCO.0000000000000158

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