Evaluation of evidence for the psychotic subtyping of post-traumatic stress disorder

Psychotic symptoms may occur in 15-64% of individuals with post-traumatic stress disorder, suggesting that the syndrome could be subtyped in a similar fashion to mood disorders. In our study of 1800 psychiatric out-patients who completed comprehensive diagnostic interviews, the lifetime prevalence of psychotic symptoms in people with PTSD was 17% (odds ratio (OR) = 3.48, 95% CI 2.32-5.21). However, after excluding people with comorbid conditions also known to be associated with psychotic symptoms this dropped to only 2.5% (OR) = 0.60, 95% CI 0.08-4.52). In contrast, rates of psychotic major depression did not change after excluding these same comorbidities. Our results do not support the official psychotic subtyping of PTSD.