An editorial comment to Peleikis DE, Varga M, Sundet K, Lorentzen S, Agartz I, Andreassen OA. Schizophrenia patients with and without post-traumatic stress disorder (PTSD) have different mood symptom levels but same cognitive functioning 
Trauma, post-traumatic stress disorder, and schizophrenia
Version of Record online: 12 MAY 2013
© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Acta Psychiatrica Scandinavica
Volume 127, Issue 6, pages 440–441, June 2013
How to Cite
Mueser, K. T. (2013), Trauma, post-traumatic stress disorder, and schizophrenia. Acta Psychiatrica Scandinavica, 127: 440–441. doi: 10.1111/acps.12075
- Issue online: 12 MAY 2013
- Version of Record online: 12 MAY 2013
The article by Peleikis and colleagues in this issue of Acta Psychiatrica Scandinavica  draws attention to the importance of the poorly recognized problem of trauma and post-traumatic stress disorder (PTSD) in people with schizophrenia. Extensive research documents that people with schizophrenia are more likely to experience trauma over the course of their lifetime, including both before and following the onset of their illness, than those in the general population [2, 3]. However, it is also well established that people with schizophrenia and other serious mental illnesses are more likely to underreport their trauma exposure than to overreport it, necessitating assessments that systematically review exposure to a broad range of different traumatic events. The lower rate of trauma exposure reported by participants in the study by Peleikis et al.  (26%)than most other studies (>70–80%) may partly reflect the method for assessing trauma, which involved asking a broad question about exposure to traumatic events, not specific questions about specific types of events.
PTSD is the most common consequence of trauma exposure, both in the general population as well as in people with serious psychiatric disorders such as schizophrenia. However, PTSD is rarely assessed in people with schizophrenia, and therefore rarely treated . There are multiple clinical implications for the failure to adequately assess and treat PTSD in individuals with schizophrenia.
Although, contrary to their hypothesis, Peleikis et al. did not find that trauma exposure and PTSD were associated with more severe cognitive impairments in people with schizophrenia, they did find that the diagnosis of PTSD was associated with more severe depression. This finding is consistent with multiple other studies of PTSD in people with schizophrenia or other serious mental illnesses . Furthermore, the strong association between PTSD and depression is consistent with findings in the general population, in which major depression is the most common comorbid disorder with schizophrenia .
The routine evaluation of exposure to different traumatic events and the presence of PTSD in people with schizophrenia could reduce the burden of anxiety and depression, and contribute to better long-term outcomes. A variety of effective treatments have been established for PTSD in the general population . There is also growing evidence that treatment models adapted for people with schizophrenia and other major mental illnesses may also be beneficial [8-10].This study by Peleikis et al. serves as an important reminder of the significant and long-term consequences of trauma in people with a serious mental illness, and should galvanize mental health service providers to evaluate trauma exposure and PTSD in all their clients, and to begin to explore what treatment options may be available for relieving their suffering.
- 7Effective Treatments for PTSD: Practice Guidelines from the International Society for Traumatic Stress Studies. 2nd edn. New York: Guilford Press, 2009., , , eds.
- 9Treatment of Posttraumatic Stress Disorder in Special Populations: A Cognitive Restructuring Program. Washington, DC: American Psychological Association, 2009., , .