The traumatic experience of first-episode psychosis: A systematic review and meta-analysis


A psychotic episode may be sufficiently traumatic to induce symptoms of post-traumatic stress disorder (PTSD), which could impact outcomes in first-episode psychosis (FEP). The objectives of this systematic review and meta-analysis were to estimate the prevalence of PTSD symptoms in relation to psychosis in FEP and to identify risk factors for the development of PTSD symptoms.

We searched electronic databases and conducted manual searching of reference lists and tables of contents to identify relevant studies. Quantitative studies were included if the population was experiencing FEP and if PTSD was measured in relation to psychosis. Prevalence of PTSD symptoms and diagnoses were meta-analyzed using a random effects model. Potential risk factors for PTSD symptoms were summarized qualitatively.

Thirteen studies were included. Eight studies assessed PTSD symptoms, three studies assessed full PTSD, and two studies assessed both. The pooled prevalence of PTSD symptoms was 42% (95% CI 30%–55%), and the pooled prevalence of a PTSD diagnosis was 30% (95% CI 21%–40%). Exploratory subgroup analyses suggest that prevalence may be higher in affective psychosis and inpatient samples. Evidence from included studies implicate depression and anxiety as potential risk factors for PTSD symptoms.

Approximately one in two people experience PTSD symptoms and one in three experience full PTSD following a first psychotic episode. Evidence-based interventions to treat PTSD symptoms in the context of FEP are needed to address this burden and improve outcomes after the first psychotic episode. Further studies are needed to clarify the associated risk factors.

I developed PTSD after my first major episode. Psychosis is horrifying.

A Canadian PBS TV documentary clip that details new research into permanently erasing PTSD trauma symptoms using the drug propranolol. The doses used are 40mg immediate release propranolol and 80mg prolonged release propranolol, both taken simultaneously straight after a 10 minute trauma re-exposure session.

(I personally have done approx 700 iterations of this).

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I still can’t go out of the house for long periods of time because I’m so afraid of te psychosis coming back. It’s crazy. A little chemical imbalance can keep you in the house for the rest of your life.