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Association between trauma exposure and delusional experiences in a large community-based sample

  • James Scott (a1), David Chant (a2), Gavin Andrews (a3), Graham Martin (a4) and John McGrath (a5)...
Abstract
Background

Surveys have found that otherwise well individuals report delusional experiences. Previous studies have shown an association between psychotic symptoms and exposure to trauma.

Aims

To explore the association between trauma and delusional experiences in a community sample.

Method

Respondents (n = 10 641) were assessed for delusional experiences, exposure to various types of traumatic experiences and the presence of post-traumatic stress disorder (PTSD). The endorsement of delusional items was examined in people exposed to traumatic events who did or did not have PTSD.

Results

Exposure to any traumatic event but without the development of PTSD was associated with increased endorsement of delusional experiences (relative risk 2.68, 95% CI 2.18–3.30) and there was a significant dose–response relationship between the number of types of traumatic events and endorsement of such experiences (χ2 =26.74, d.f. =2, P < 0.001). A diagnosis of PTSD further increased endorsement of delusional experiences (RR = 9.24, 95% CI 6.95–12.27). The association between PTSD and delusional experiences remained significant after adjusting for factors associated with psychotic symptoms.

Conclusions

Further investigation into the pathways between trauma, delusions and psychosis may provide insights into shared aetiological mechanisms underpinning these conditions.

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Copyright
Corresponding author
Professor John McGrath, Queensland Centre for Mental Health Research, Park Centre for Mental Health, Wacol, QLD 4076, Australia. Tel: +61 73271 8694; fax: +61 7 3271 8698; email: john_mcgrath@qcsr.uq.edu.au
Footnotes
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Declaration of interest

None.

Footnotes
References
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Association between trauma exposure and delusional experiences in a large community-based sample

  • James Scott (a1), David Chant (a2), Gavin Andrews (a3), Graham Martin (a4) and John McGrath (a5)...
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eLetters

The importance of Combat related Trauma and Psychosis.

Mark Agius, Senior Research Fellow
29 May 2007

Scott et al [2007] have very appropriately brought to our attention the relationship between Trauma exposure and psychotic illness.In the UK literature, much attention has been paid to one particular form of trauma in relation to psychosis; that of child sexual abuse or rape. Scott has however rightly pointed out that other forms of trauma can have similar effects. We would like to draw attention to the effect of another form of trauma, alas all too common due to man’s inhumanity to man- that of combat relatedtrauma. Some of us first reported on co-morbid PTSD and psychotic symptoms during the wars in Croatia and Bosnia and Herzegovina.[Ivezic 2000] . Indeed, the Croatian Hospital Discharges Database [Hrabak-Zerjavic 2005] demonstrated increase of hospitalisations of PTSD and the psychiatric observations have shown a significant proportion of psychotic symptoms in patients with PTSD after the war in Croatia [Mimica 2005].

Others of us have reported on the utility of atypical anti-psychoticsfor the treatment of such patients. [Kozaric-Kovacic 2006]. Those of us who work in the UK can bear witness to the difficulty of treating patientswith co-morbid Psychosis and PTSD who have come to the UK as refugees fromthe wars in the Balkans.Much more needs to be established regarding this form of mental illness, including which are the groups of subjects who are most vulnerable to developing a combination of PTSD and Psychosis. We would suggest that the possibility of an developing psychotic illness should be born in mind in the case of those who return to their homes after taking part in present conflict suffering from PTSD symptoms.

ReferencesScott J, Chant D, Andrews G, Martin G, McGrath J .2007 Association betweentrauma exposure and delusional experiencesin a large community based sample. British Journal of Psychiatry 190;339-343.

Ivezic S, Bagaric A, Oruc L, Mimica N, Ljubin T 2000. Psychotic symptoms and comorbid psychiatric disorders in Croatian combat-related posttraumatic stress disorder patients. Croat Med J 41:179-83.Hrabak-Zerjavic V,2005 Silobrcic Radic M.Mental disorders in Croatia-Croatian Mental Health Registries. 2005 Advancing Practice in Bedfordshire2;[supplement 2005] 20-23.Mimica N 2005 The Croatian Mental Health Registers- Psychiatrist’s Observations Advancing Practice in Bedfordshire 2;[supplement 2005] 19-20.Kozaric-Kovacic D, Pivac N. 2006 Pharmacotherapy of treatment-resstant combat related posttraumatic stress disorder with psychotic features CroatMed J. 47;440-451
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