Features of clinical diagnosis of post-traumatic stress disorder with psychotic symptoms | Український Медичний Часопис

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.

References

1. Казан Е.М., Заболотнюк І.О., Ковба М.В., Голубовська О.М. (2023) Посттравматичний стресовий розлад — проблема поствоєнного суспільства. Психологія особистості фахівця в умовах воєнного часу та поствоєнної реабілітації: матеріали VІІІ Всеукраїнської науково-практичної конференції (27 жовтня 2023 р.). Львів, Львівський державний ун-т внутрішніх справ, 316 с.
2. moz.gov.ua/article/news/kilkist-pacientiv-zi-vstanovlenim-diagnozom-ptsr-v-ukraini-zrostae-scho-treba-znati-pro-posttravmatichnij-stresovij-rozlad?__cf_chl_tk=y.mFOul1ru83aeVdGQUnA0oY0vGkDEltLuJ4qSHr1p4-1713175255-0.0.1.1-1834.
3. МОЗ України (2016) Наказ МОЗ України від 23.02.2016 р. № 121 «Про затвердження та впровадження медико-технологічних документів зі стандартизації медичної допомоги при посттравматичному стресовому розладі».
4. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 5th ed., American Psychiatric Publishing, 2013.
5. Чабан О.С., Хаустова О.О. (ред.) (2021) Практична психосоматика: діагностичні шкали. Навчальний посібник. Видавничий дім Медкнига, Київ, 200 с.
6. http://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp.
7. http://www.upma.online/wp-content/uploads/2023/08/04_TRANSKRYPT_Oleg_CHaban_Lektsiya_2_PTSR_chastyna_1.pdf.
8. Compean E., Hamner M. (2019) Posttraumatic stress disorder with secondary psychotic features (PTSD-SP): Diagnostic and treatment challenges. Progr. Neuro-Psychopharmacol. Biol. Psychiatr., 88: 265–275.
9. Kastelan A., Franciskovic T., Moro L. et al. (2007) Psychotic symptoms in combat-related post-traumatic stress disorder. Mil. Med., 172: 273–277.
10. Kozaric-Kovacic D., Borovecki A. (2005) Prevalence of Psychotic Comorbidity in Combat-Related Post-Traumatic Stress Disorder. Mil. Med., 170: 223–226.
11. Hamner M.B. (1997) Psychotic features and combat-associated PTSD. Depress Anxiety, 5: 34–38.
12. Sareen J., Cox B.J., Goodwin R.D., Asmundson G.J. (2005) Co-occurrence of posttraumatic stress disorder with positive psychotic symptoms in a nationally representative sample. J. Trauma Stress, 18: 313–322.
13. Sautter F.J., Brailey K., Uddo M.M. et al. (1999) PTSD and comorbid psychotic disorder: comparison with veterans diagnosed with PTSD or psychotic disorder. J. Trauma Stress, 12: 73–88.