Trauma-Triggered Psychotic Episodes in Post-traumatic Stress Disorder: A Case Report

Post-traumatic stress disorder (PTSD) is a clinically complex condition, and its intrinsically intense emotional burden may, in some cases, be associated with trauma reactivation that precipitates transient psychotic symptoms, particularly in individuals exposed to chronic interpersonal trauma. Although psychosis is not part of PTSD diagnostic criteria, trauma-related psychotic experiences have been documented and may emerge in the context of hyperarousal, intrusive recollections, and perceived threat amplification. We present the case of a 46-year-old woman with PTSD following prolonged intimate partner violence who experienced three brief psychotic episodes, each triggered by emotionally salient trauma cues: a difficult separation following an abusive relationship, the postpartum period marked by the reactivation of memories of reproductive coercion, and an unexpected encounter with her former abuser. The most recent episode involved acute persecutory delusions centered on digital surveillance, accompanied by intense anxiety and hyperarousal, with partial insight. Symptoms resolved fully within weeks after resuming psychological and psychiatric follow-up, including antipsychotic treatment. Notably, each episode was separated by several years of complete remission, with the patient maintaining stable functioning even after discontinuation of antipsychotic therapy. This case illustrates how trauma triggers can be associated with brief psychotic experiences in susceptible individuals and underscores the importance of recognizing trauma-related mechanisms to avoid misdiagnosis with primary psychotic disorders. Early identification, psychoeducation, supportive and trauma-focused interventions, and short-term antipsychotic therapy can lead to rapid resolution and sustained stability.