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Psychotic symptoms in combat-related posttraumatic stress disorder
D David1, G S Kutcher, E I Jackson
1University of Miami, Department of Psychiatry and Behavioral Sciences, and the Miami Veterans Affairs Medical Center, Fla 33136, USA.
The Journal of Clinical Psychiatry
|March 13, 1999
Summary
Psychotic symptoms are present in 40% of combat veterans with posttraumatic stress disorder (PTSD). These symptoms are linked to major depression and are more common in minority veterans, possibly due to comorbidity.
Area of Science:
- Psychiatry
- Clinical Psychology
- Veterans' Mental Health
Background:
- Posttraumatic stress disorder (PTSD) frequently co-occurs with other mental health conditions.
- Psychotic symptoms are noted in PTSD, particularly in Hispanic veterans, but require further investigation.
- Understanding the relationship between PTSD, psychosis, and comorbidity is crucial for effective treatment.
Purpose of the Study:
- To assess psychotic symptoms in combat veterans with PTSD using DSM-III-R criteria.
- To determine the association of psychotic symptoms with psychiatric comorbidity and ethnicity.
- To investigate the role of comorbid disorders in the manifestation of psychotic symptoms.
Main Methods:
- A cohort of 53 male combat veterans with primary PTSD diagnosis was assessed.
- Psychotic symptoms and Axis I disorders were evaluated.
- Statistical analyses (chi-square, t tests) examined associations between psychotic symptoms, comorbidity, and symptom severity.
Main Results:
- 40% of veterans reported psychotic symptoms in the past 6 months, primarily auditory hallucinations.
- Psychotic symptoms were significantly associated with current major depression but not substance use disorders or PTSD severity.
- Psychotic symptoms and major depression were more prevalent in minority (Hispanic, black) veterans compared to white veterans.
Conclusions:
- Psychotic symptoms are a notable feature in combat-related PTSD.
- Major depression is associated with psychotic symptoms in this population.
- The higher prevalence of psychotic symptoms in minority veterans may be linked to comorbid conditions.