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Continuing lack of evidence for the psychotic subtyping of PTSD

Published online by Cambridge University Press:  02 January 2018

Elisa Brietzke
Affiliation:
Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil, email: elisabrietzke@hotmail.com
André Zugman
Affiliation:
Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
Elson Asevedo
Affiliation:
Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
Rodrigo Mansur
Affiliation:
Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
Graccielle Rodrigues da Cunham
Affiliation:
Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
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Abstract

Type
Columns
Copyright
Copyright © Royal College of Psychiatrists, 2011 

Gaudiano & Zimmerman Reference Gaudiano and Zimmerman1 conclude that psychotic symptoms in post-traumatic stress disorder (PTSD) are associated with comorbid conditions, especially major depressive disorders, and that their results therefore do not support the existence of a psychotic subtype of PTSD. However, they did not evaluate certain factors that might be responsible for misinterpretation of their results. First, they did not report the severity of post-traumatic and depressive symptoms. It is possible that patients with PTSD without comorbid depressive disorder had a milder post-traumatic disorder and consequently less probability of presenting with psychotic symptoms. Second, in clinical practice the congruence of delusions and hallucinations with traumatic events seems to be distributed across a continuum: at one extreme there is complete congruence with trauma and at the other there are exuberant and bizarre symptoms similar to those described in schizophrenia. The elucidation of the possible existence of a psychotic subtype of PSTD must necessarily include the development of adequate instruments to measure severity and congruence of psychotic symptoms in ‘non-psychotic’ conditions (e.g. mood and anxiety disorders), as well as their biological correlates.

Footnotes

Edited by Kiriakos Xenitidis and Colin Campbell

References

1 Gaudiano, BA, Zimmerman, M. Evaluation of evidence for the psychotic subtyping of post-traumatic stress disorder. Br J Psychiatry 2010; 197: 326–7.CrossRefGoogle ScholarPubMed
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