(This article is from January, but still.)
The psychotic symptoms associated with schizophrenia appear in a significant number of veterans with post-traumatic stress disorder, raising the following question: Do these patients have a subtype of PTSD, comorbid schizophrenia or prodromal schizophrenia?
Making the right determination has significant implications for the course of treatment and outcomes but is very challenging in single, short clinical interactions, according to VA clinicians.
“About 10% of patients with PTSD experience psychosis,” said Lynn DeLisi, MD, a psychiatrist in the VA Boston Healthcare system, a professor of psychiatry at Harvard Medical School and founding editor of the journal Schizophrenia Research. “And we just don’t know very much.
As about 70% of returning veterans receive a diagnosis of PTSD, the 10% with psychosis represents a significant number of veterans. Getting their diagnosis right is critical, DeLisi emphasized.
“The course of illness, prognosis and treatment for schizophrenia are very different than for PTSD,” she told U.S. Medicine, noting that a clinician might recommend non-psychopharmaceutical therapy for PTSD, for instance, where schizophrenics would typically be kept on neuroleptic medications. Delaying appropriate treatment for schizophrenia could lead to significant worsening of overall functioning and make future therapy more difficult.
“The problem is that PTSD develops in military recruits while in combat, then young soldiers come back from service in their early 20s, the peak age for developing schizophrenia,” DeLisi pointed out.