Validity of 'post-traumatic stress disorder with secondary psychotic features': a review of the evidence

Acta Psychiatr Scand. 2009 Jan;119(1):15-24. doi: 10.1111/j.1600-0447.2008.01252.x. Epub 2008 Aug 29.


Objective: To review the evidence from empirical studies regarding the validity of 'post-traumatic stress disorder with secondary psychotic features' (PTSD-SP) as a separate diagnostic entity.

Method: The authors performed a review tracing publications between 1980 and January 2008.

Results: Twenty-four comparative studies were included. These studies indicate that PTSD-SP is a syndrome that comprises PTSD-symptoms followed in time by the additional appearance of psychotic features. The psychotic features are not confined to episodes of re-experiencing, but remain present continuously. PTSD-SP seems to have some biological features differentiating it from schizophrenia and PTSD, e.g. there are differences in smooth pursuit eye movement patterns, concentrations of corticotropin-releasing factor and dopamine beta-hydroxylase activity.

Conclusion: There is currently not yet full support for PTSD-SP as a nosological entity. However, the delineation of PTSD-SP from other psychiatric syndromes is notable and biological studies seem to support the validity as a separate diagnostic entity.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Chronic Disease
  • Comorbidity
  • Delusions / classification
  • Delusions / diagnosis
  • Delusions / psychology
  • Diagnosis, Differential
  • Evidence-Based Medicine
  • Hallucinations / classification
  • Hallucinations / diagnosis
  • Hallucinations / psychology
  • Humans
  • Psychiatric Status Rating Scales
  • Psychotic Disorders / classification
  • Psychotic Disorders / diagnosis*
  • Psychotic Disorders / psychology
  • Reality Testing
  • Risk Factors
  • Stress Disorders, Post-Traumatic / classification
  • Stress Disorders, Post-Traumatic / diagnosis*
  • Stress Disorders, Post-Traumatic / psychology