title: Does a study focused on trauma encourage patients with psychotic symptoms to seek treatment?
abstract: OBJECTIVE
  This study explored, in a randomized trial of psychotherapies for posttraumatic stress disorder (PTSD), why a surprisingly high percentage of study applicants presented with psychotic symptoms and what clinical implications this finding might prompt.
  
  
  METHODS
  Raters reviewed the records of applicants who completed an initial psychiatric interview and compared those who had psychotic symptoms with all other study-eligible participants and with those who ultimately were enrolled in the study.
  
  
  RESULTS
  Of 223 consecutively evaluated individuals who applied for study entry, 38 (17%) were found ineligible because of psychotic symptoms. These individuals were more likely to be male and to have suffered child abuse, and they had taken a greater number of lifetime medications than study-eligible applicants. Most individuals with psychotic symptoms met DSM-IV criteria for PTSD.
  
  
  CONCLUSIONS
  A trauma-informed framework might be a helpful part of a comprehensive treatment plan for some individuals with psychotic symptoms, possibly leading to greater treatment engagement and more positive outcomes.
authors.affiliation: Trauma and PTSD Program, New York State Psychiatric Institute, USA.
authors.forename: Lawrence V
authors.initials: LV
authors.lastname: Amsel
authors.forename: Noel
authors.initials: N
authors.lastname: Hunter
authors.forename: San
authors.initials: S
authors.lastname: Kim
authors.forename: Kinga E
authors.initials: KE
authors.lastname: Fodor
authors.forename: John C
authors.initials: JC
authors.lastname: Markowitz
mesh_terms: D000328:Adult; D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000706:statistics & numerical data; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D018579:Patient Selection; D011613:Psychotherapy; D011618:Psychotic Disorders / Q000453:epidemiology*; D016032:Randomized Controlled Trials as Topic; D035842:Research Subjects / Q000523:psychology*; D012189:Retrospective Studies; D017678:Sex Distribution; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*