Childhood trauma and posttraumatic stress disorder in patients with psychosis: clinical challenges and emerging treatments.

摘要

PURPOSE OF REVIEW: To review the current literature on childhood trauma and emerging treatments for posttraumatic stress disorder (PTSD), one of its most prevalent consequences, in patients with psychotic disorders. RECENT FINDINGS: Of patients with psychosis, 40-50% report either childhood sexual abuse or childhood physical abuse, and 11-46% fulfil a diagnosis of PTSD. About one-third of patients report childhood emotional abuse in the absence of other forms of childhood trauma. More robust evidence is mounting to support the role of childhood trauma in the aetiology of psychosis, but more research is needed to understand the underlying mechanisms. Patients with a history of childhood trauma and/or PTSD have a more severe clinical profile compared with those without these experiences, worse overall functioning, and lower remission rates. Research suggests that instruments assessing childhood trauma and PTSD developed for the general population are also appropriate for use among people with psychosis, and trauma-focussed treatments can be used safely and effectively in this group. SUMMARY: Childhood trauma and its consequences are highly prevalent among patients with psychosis and severely affect the course and outcome. Treatment approaches appropriate for this population need to be further evaluated and implemented into routine practice.