The role of trauma and PTSD-related symptoms for dissociation and psychopathological distress in inpatients with schizophrenia.
BACKGROUND
To investigate the relationship between dissociative experiences, psychopathological distress, a history of trauma and posttraumatic symptoms in adult schizophrenia.


METHODS
Eighty-seven schizophrenic inpatients returned self-questionnaires [Dissociative Experience Scale (DES); Symptom Checklist (SCL-90-R); PTSD Symptom Scale (PDS)]. Based upon this self-rating, 14 of the participants fulfilled the cut-off definition of PTSD according to DSM-IV criteria, 43 had a history of trauma without a self-rated diagnosis of PTSD. DES scores were also compared to a convenience sample of 297 non-clinical controls.


RESULTS
We found no significant impact of trauma alone but a significant influence of posttraumatic symptomatology on the level of current psychopathological distress (GSI) and the DES subscale absorption. However, in logistic regression, posttraumatic symptomatology was associated with GSI but not with DES. Schizophrenic patients even without trauma or posttraumatic symptoms had significantly higher scores in all three DES subscales than non-clinical controls.


CONCLUSIONS
Pronounced posttraumatic symptoms in schizophrenia are associated with severe additional psychopathological distress whereas the increase in dissociation (absorption) in this group of patients may be secondary to the increase in symptom load. However, schizophrenia itself seems to be associated independently from trauma and pathological posttraumatic conditions with a broad range of dissociative symptoms.
Vogel
Matthias
M
Department of Psychiatry and Psychotherapy, Ernst Moritz Arndt University, Greifswald, Germany. matthias.vogel@uni-greifswald.de
Spitzer
Carsten
C
Barnow
Sven
S
Freyberger
Harald J
HJ
Grabe
Hans Jörgen
HJ
D000293:Adolescent; D000328:Adult; D004213:Dissociative Disorders / Q000150:complications / Q000523:psychology*; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000150:complications; D012565:Schizophrenic Psychology; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*