Validity of ‘post-traumatic stress disorder with secondary psychotic features’: a review of the evidence

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ObjectiveTo review the evidence from empirical studies regarding the validity of ‘post-traumatic stress disorder with secondary psychotic features’ (PTSD-SP) as a separate diagnostic entity.MethodThe authors performed a review tracing publications between 1980 and January 2008.ResultsTwenty-four comparative studies were included. These studies indicate that PTSD-SP is a syndrome that comprises PTSD-symptoms followed in time by the additional appearance of psychotic features. The psychotic features are not confined to episodes of re-experiencing, but remain present continuously. PTSD-SP seems to have some biological features differentiating it from schizophrenia and PTSD, e.g. there are differences in smooth pursuit eye movement patterns, concentrations of corticotropin-releasing factor and dopamine β-hydroxylase activity.ConclusionThere is currently not yet full support for PTSD-SP as a nosological entity. However, the delineation of PTSD-SP from other psychiatric syndromes is notable and biological studies seem to support the validity as a separate diagnostic entity.

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