PTSD prevalent in serious mental illness patients

By Mark Cowen

Post-traumatic stress disorder (PTSD) is common among patients with serious mental illnesses, and is associated with an increased risk for suicide attempts, Spanish researchers report.

In a study of 102 patients with schizophrenia (51%), bipolar disorder (39.2%), or schizoaffective disorder (9.8%), the team found that around one in six met the full criteria for PTSD, of whom nearly two-thirds had a history of suicide attempts.

"We believe that this is the first study in Spain to show a higher rate of PTSD in patients with serious mental illnesses, coinciding with previous studies in other countries, than has been found in studies of PTSD prevalence in the general population," comment María-José Álvarez (Vic Hospital Consortium, Catalonia, Spain) and team.

All of the participants (52.9% men), who had a mean age of 39.4 years, were assessed using the Brief Psychiatric Rating Scale and completed the Traumatic Life Events Questionnaire and the Distressing Event Questionnaire.

Almost half (47.5%) of the patients reported experiencing one or more types of childhood trauma, with women having a nonsignificantly higher prevalence of traumatic events than men, at 56.3% versus 36.6%.

Overall, 15.1% of participants met the full DSM-IV criteria for PTSD, with no significant differences among the three diagnostic groups.

Of note, only two of the 14 individuals who met the full criteria for PTSD had previously been diagnosed with the condition.

The researchers also found that patients with PTSD were nearly twice as likely to have made at least one suicide attempt as those without, at 64.3% versus 37.4%.

"This study found a significantly higher rate of suicide attempts among patients with schizophrenia or bipolar disorder and coexisting PTSD," summarize Álvarez et al in the Journal of Nervous and Mental Disease.

They conclude: "Given recent reports of the effectiveness of cognitive behavioral therapy for PTSD in psychotic patients, systematic assessment of the clinical records of patients with serious mental illnesses to determine traumas they have experienced and the possible existence of PTSD symptoms would improve the treatment of this subgroup of patients."

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