A significant proportion of people with psychotic disorders report traumatic experiences in childhood, such as sexual and physical abuse. Similarly, a proportion of childhood trauma (CT) survivors report psychotic symptoms such as hallucinations and delusions. Are these psychotic symptoms in trauma survivors part of the sequelae of CT or do they co-occur by chance? Much of the research into the relationship between CT and psychosis has suffered from a lack of methodological rigor and thus has failed to answer this question. Past reviews have paid little attention to these methodological problems (Read 1997, 2005; Morrison 2003). The aim of this review was to synthesize and critically evaluate the evidence.
Medline and Psychinfo databases were systematically searched and papers identified were assessed according to eligibility criteria. The reference sections of identified papers were also searched.
Forty-nine papers were identified. The rates of CT reported in groups with psychosis ranged between 19% and 83%. Child sexual abuse prevalence rates ranged between 17% and 79%. Reports of child physical abuse ranged from 10% to 61%. When compared with nonclinical controls, those with psychosis reported more trauma. Epidemiological studies investigating the relationship of CT to psychotic diagnosis and symptoms have found mixed results. However, all studies have methodological problems.
These studies tentatively suggest a relationship between CT and psychosis. Further good quality research is needed to clarify any association.