Complex PTSD among persons with serious mental illness receiving community mental health services

Complex PTSD (CPTSD) is often associated with prolonged or repeated trauma exposure and the experience of intimate partner and childhood abuse. CPTSD includes the criteria for PTSD (re-experiencing, avoidance, and sense of threat) in addition to three criteria for self-organization disturbances (affective dysregulation, negative self-concept, and relational disturbance).

This study aimed to assess profiles of CPTSD symptoms and their association with psychiatric distress among people with co-occurring Serious Mental Illness (SMI; schizophrenia/schizoaffective, bipolar, and treatment-refractory major depression). Treatment-seeking participants (N = 307) with SMI and PTSD diagnoses were drawn from two randomized controlled trials. Distinct symptom profiles were assessed using Latent Profile Analysis (LPA).

A model with three classes best fit the data with the most parsimonious interpretation: 26.7% (n = 82) in the PTSD class, 43.7% (n = 134) in the CPTSD class, and 29.6% (n = 91) in the CPTSD+ Borderline Personality Disorder (BPD) class. The CPTSD+BPD class showed the highest levels of psychiatric symptoms, followed by the CPTSD and PTSD groups, respectively.

The results demonstrate the heterogeneity in symptom presentation across the PTSD classes and that, despite similar diagnoses, individuals may present with varying symptom patterns. This emphasizes the importance of studying CPTSD in subpopulations of persons with SMI.