The purpose: to investigate clinical differences in the manifestations and course of psychotic symptoms in post-traumatic stress disorder (PTSD) and in endogenous psychotic diseases, the specified features compared to the course of PTSD with and without other types of additional symptoms. Object and research methods. Patients, military personnel who experienced psychological trauma as a result of military operations, and who were diagnosed with PTSD with additional symptoms, in particular, with psychotic symptoms, were studied. The history of patients treated in the health care facility of the Ministry of Defense of Ukraine was studied, diagnostic criteria were determined, symptoms were investigated, differential diagnosis with endogenous psychotic diseases was carried out, and their clinical differences were shown. Results. PTSD with secondary psychotic symptoms can be considered a more complex variant compared to PTSD without psychotic symptoms, as evidenced by numerous studies and our clinical experience. Conclusion. Correct and timely differential diagnosis with a psychotic register is important, because an incorrectly established diagnosis can lead to increased stigmatization of the patient in society, which, in turn, will negatively affect the course of the disease.