Trauma e Psicose: Uma Análise Crítica da Literatura
DOI:
https://doi.org/10.51338/rppsm.607Palavras-chave:
Acontecimentos que Mudam a Vida, Perturbações Psicóticas, Perturbações de Stress Pós-Traumático, Trauma PsicológicoResumo
O conhecimento acerca do trauma, nomeadamente da sua relação com a psicose, tem sido objeto de estudo intensivo nos tempos recentes. Com o objetivo de apresentar o estado da arte sobre a interação entre trauma e psicose, realizou-se uma revisão narrativa da literatura sobre o tema, procedendo-se a uma subsequente análise crítica dos construtos fenotípicos que se crê serem marcadores de risco ou intermediários na relação bidirecional entre trauma e psicose. Eventos e perturbações traumáticas são frequentemente reportados em indivíduos com psicose, podendo as duas condições estabelecer-se segundo quatro tipos de relação: psicose como resultado de experiências traumáticas; perturbação de stress pós-traumático (PSPT) pós-psicótica; psicose como uma dimensão da PSPT; e PSPT e psicose comórbidas. A interação entre trauma e psicose supõe-se mediada através de disfunções nos domínios cognitivo, emocional, socioambiental e neurobiológico. O conhecimento aprofundado da complexa interação entre trauma e psicose permitirá aos serviços de saúde mental desenvolverem estratégias preventivas e terapêuticas mais dirigidas.
Downloads
Referências
Substance Abuse and Mental Health Services Administration. SAMHSA's concept of trauma and guidance for a trauma- informed approach. Rockville: SAMHSA; 2014.
Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB. Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry. 1995;52:1048-60. doi:10.1001/archpsyc.1995.03950240066012. DOI: https://doi.org/10.1001/archpsyc.1995.03950240066012
Read J, van Os J, Morrison AP, Ross CA. Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Acta Psychiatr Scand. 2005;112:330-50. doi:10.1111/j.1600-0447.2005.00634.x. DOI: https://doi.org/10.1111/j.1600-0447.2005.00634.x
Hardy KV, Mueser KT. Editorial: Trauma, psychosis and post- traumatic stress disorder. Front Psychiatry. 2017;8:220. doi:10.3389/fpsyt.2017.00220. DOI: https://doi.org/10.3389/fpsyt.2017.00220
Shevlin M, Dorahy M, Adamson G. Childhood traumas and hallucinations: an analysis of the National Comorbidity Survey. J Psychiatr Res. 2007;41:222-8. doi:10.1016/j.jpsychires.2006.03.004. DOI: https://doi.org/10.1016/j.jpsychires.2006.03.004
Bentall RP, Wickham S, Shevlin M, Varese F. Do specific early- life adversities lead to specific symptoms of psychosis? A study from the 2007 the Adult Psychiatric Morbidity Survey. Schizophr Bull. 2012;38:734-40. doi:10.1093/schbul/sbs049. DOI: https://doi.org/10.1093/schbul/sbs049
Varese F, Smeets F, Drukker M, Lieverse R, Lataster T, Viechtbauer W, et al. Childhood adversities increase the risk of psychosis: a meta- analysis of patient- control, prospective- and cross- sectional cohort studies. Schizophr Bull. 2012;38:661-71. doi:10.1093/schbul/sbs050. DOI: https://doi.org/10.1093/schbul/sbs050
Kraan T, Velthorst E, Smit F, de Haan L, van der Gaag M. Trauma and recent life events in individuals at ultra high risk for psychosis: review and meta- analysis. Schizophr Res. 2015;161:143-9. doi:10.1016/j.schres.2014.11.026. DOI: https://doi.org/10.1016/j.schres.2014.11.026
Mayo D, Corey S, Kelly LH, Yohannes S, Youngquist AL, Stuart BK, et al. The role of trauma and stressful life events among individuals at clinical high risk for psychosis: a review. Front Psychiatry. 2017;8:55. doi:10.3389/fpsyt.2017.00055. DOI: https://doi.org/10.3389/fpsyt.2017.00055
Grubaugh AL, Zinzow HM, Paul L, Egede LE, Frueh BC. Trauma exposure and posttraumatic stress disorder in adults with severe mental illness: a critical review. Clin Psychol Rev. 2011;31:883-99. doi:10.1016/j.cpr.2011.04.003. DOI: https://doi.org/10.1016/j.cpr.2011.04.003
Goodman LA, Salyers MP, Mueser KT, Rosenberg SD, Swartz M, Essock SM, et al. Recent victimization in women and men with severe mental illness: prevalence and correlates. J Trauma Stress. 2001;14:615-32. doi:10.1023/A:1013026318450. DOI: https://doi.org/10.1023/A:1013026318450
Frueh BC, Knapp RG, Cusack KJ, Grubaugh AL, Sauvageot JA, Cousins VC, et al. Patients' reports of traumatic or harmful experiences within the psychiatric setting. Psychiatr Serv. 2005;56:1123-33. doi:10.1176/appi.ps.56.9.1123. DOI: https://doi.org/10.1176/appi.ps.56.9.1123
Reddy LF, Spaulding WD. Understanding adverse experiences in the psychiatric institution: the importance of child abuse histories in iatrogenic trauma. Psychol Serv. 2010;7:242-53. doi:10.1037/a0020316. DOI: https://doi.org/10.1037/a0020316
Buckley PF, Miller BJ, Lehrer DS, Castle DJ. Psychiatric comorbidities and schizophrenia. Schizophr Bull. 2009;35:383-402. doi:10.1093/schbul/sbn135. DOI: https://doi.org/10.1093/schbul/sbn135
Cragin CA, Straus MB, Blacker D, Tully LM, Nien- dam TA. Early psychosis and trauma-related disorders: clinical practice guidelines and future directions. Front Psychiatry. 2017;8:33. doi:10.3389/fpsyt.2017.00033. DOI: https://doi.org/10.3389/fpsyt.2017.00033
Panayi P, Berry K, Sellwood W, Campodonico C, Bentall RP, Varese F. The role and clinical correlates of complex post-traumatic stress disorder in people with psychosis. Front Psychol. 2022;13:791996. doi:10.3389/fpsyg.2022.791996. DOI: https://doi.org/10.3389/fpsyg.2022.791996
Stevens LH, Spencer HM, Turkington D. Identifying four subgroups of trauma in psychosis: vulnerability, psychopathology, and treatment. Front Psychiatry. 2017;8:21. doi:10.3389/fpsyt.2017.00021. DOI: https://doi.org/10.3389/fpsyt.2017.00021
Aakre JM, Brown CH, Benson KM, Drapalski AL, Gearon JS. Trauma exposure and PTSD in women with schizophrenia and coexisting substance use disorders: comparisons to women with severe depression and substance use disorders. Psychiatry Res. 2014;220:840-5. doi:10.1016/j.psychres.2014.10.004. DOI: https://doi.org/10.1016/j.psychres.2014.10.004
Sahin S, Yuksel C, Guler J, Karadayi G, Akturan E, Gode E, et al. The history of childhood trauma among individuals with ultra high risk for psychosis is as common as among patients with first-episode schizophrenia. Early Interv Psychiatry. 2013;7:414-20. doi:10.1111/eip.12022. DOI: https://doi.org/10.1111/eip.12022
Strakowski SM, Keck PE Jr, McElroy SL, Lonczak HS, West SA. Chronology of comorbid and principal syndromes in first-episode psychosis. Compr Psychiatry. 1995;36:106-12. doi:10.1016/s0010-440x(95)90104-3. DOI: https://doi.org/10.1016/S0010-440X(95)90104-3
Deering CG, Glover SG, Ready D, Eddleman HC, Alarcon RD. Unique patterns of comorbidity in posttraumatic stress disorder from different sources of trauma. Compr Psychiatry. 1996;37:336-46. doi:10.1016/s0010-440x(96)90015-2. DOI: https://doi.org/10.1016/S0010-440X(96)90015-2
Hamner MB. Clozapine treatment for a veteran with comorbid psychosis and PTSD. Am J Psychiatry. 1996;153:841. doi:10.1176/ajp.153.6.841. DOI: https://doi.org/10.1176/ajp.153.6.841
David D, Kutcher GS, Jackson EI, Mellman TA. Psychotic symptoms in combat-related posttraumatic stress disorder. J Clin Psychiatry. 1999;60:29-32. doi:10.4088/jcp.v60n0106. DOI: https://doi.org/10.4088/JCP.v60n0106
Hamner MB, Frueh BC, Ulmer HG, Huber MG, Twomey TJ, Tyson C, et al. Psychotic features in chronic posttraumatic stress disorder and schizophrenia: comparative severity. J Nerv Ment Dis. 2000;188:217-21. doi:10.1097/00005053-200004000-00004. DOI: https://doi.org/10.1097/00005053-200004000-00004
Hamner MB, Frueh BC, Ulmer HG, Arana GW. Psychotic features and illness severity in combat veterans with chronic posttraumatic stress disorder. Biol Psychiatry. 1999;45:846-52. doi:10.1016/s0006-3223(98)00301-1. DOI: https://doi.org/10.1016/S0006-3223(98)00301-1
Scott JG, Nurcombe B, Sheridan J, McFarland M. Hallucinations in adolescents with post-traumatic stress disorder and psychotic disorder. Australas Psychiatry. 2007;15:44-8. doi:10.1080/10398560601083084. DOI: https://doi.org/10.1080/10398560601083084
Compean E, Hamner M. Posttraumatic stress disorder with secondary psychotic features (PTSD-SP): Diagnostic and treatment challenges. Prog Neuropsychopharmacol Biol Psychiatry. 2019;88:265-75. doi:10.1016/j.pnpbp.2018.08.001. DOI: https://doi.org/10.1016/j.pnpbp.2018.08.001
Mueser KT, Rosenberg SD, Goodman LA, Trumbetta SL. Trauma, PTSD, and the course of severe mental illness: an interactive model. Schizophr Res. 2002;53:123-43. doi:10.1016/s0920-9964(01)00173-6. DOI: https://doi.org/10.1016/S0920-9964(01)00173-6
Zubin J, Spring B. Vulnerability- a new view of schizophrenia. J Abnorm Psychol. 1977;86:103-26. doi:10.1037//0021-843x.86.2.103. DOI: https://doi.org/10.1037/0021-843X.86.2.103
Coentre R, Power P. A diagnostic dilemma between psychosis and post-traumatic stress disorder: a case report and review of the literature. J Med Case Rep. 2011;5:97. doi:10.1186/1752-1947-5-97. DOI: https://doi.org/10.1186/1752-1947-5-97
Alameda L, Rodriguez V, Carr E, Aas M, Trotta G, Marino P, et al. A systematic review on mediators between adversity and psychosis: Potential targets for treatment. Psychol Med. 2020;50:1966-76. doi:10.1017/S0033291720002421. DOI: https://doi.org/10.1017/S0033291720002421
Moskowitz A, Dorahy MJ, Schäfer I, editors. Psychosis, trauma and dissociation: evolving perspectives on severe psychopathology. Hoboken: John Wiley & Sons; 2019. DOI: https://doi.org/10.1002/9781118585948
Grubaugh AL, Cusack KJ, Zinzow HM. "Trumping rules" affect diagnoses of persons with severe mental illness. Psychiatr Serv. 2008;59:1219-20. doi:10.1176/ps.2008.59.10.1219. DOI: https://doi.org/10.1176/appi.ps.59.10.1219
Frueh BC, Cusack KJ, Hiers TG, Monogan S, Cousins VC, Cavenaugh SD. Improving public mental health services for trauma victims in South Carolina. Psychiatr Serv. 2001;52:812-4. doi:10.1176/appi.ps.52.6.812. DOI: https://doi.org/10.1176/appi.ps.52.6.812
Mueser KT, Goodman LA, Trumbetta SL, Rosenberg SD, Osher FC, Vidavet R, et al. Trauma and posttraumatic stress disorder in severe mental illness. J Consult Clin Psychol. 1998;66:493-9. doi:10.1037/0022-006x.66.3.493. DOI: https://doi.org/10.1037/0022-006X.66.3.493
Tong J, Simpson K, Alvarez-Jimenez M, Bendall S. Talking about trauma in therapy: perspectives from young people with post-traumatic stress symptoms and first episode psychosis. Early Interv Psychiatry. 2019;13:1236-44. doi:10.1111/eip.12761. DOI: https://doi.org/10.1111/eip.12761
Tong J, Simpson K, Alvarez-Jimenez M, Bendall S. Distress, psychotic symptom exacerbation, and relief in reaction to talking about trauma in the context of beneficial trauma therapy: perspectives from young people with post-traumatic stress disorder and first episode psychosis. Behav Cogn Psychother. 2017;45:561-76. doi:10.1017/S1352465817000236. DOI: https://doi.org/10.1017/S1352465817000236
Blanch AK, Hardy K, Loewy R, Niendam T. Trauma, PTSD, and First Episode Psychosis. Alexandria: National Association of State Mental Health Program Directors; 2018.
Cusack KJ, Grubaugh AL, Knapp RG, Frueh BC. Unrecognized trauma and PTSD among public mental health consumers with chronic and severe mental illness. Community Ment Health J. 2006;42:487-500. doi:10.1007/s10597-006-9049-4. DOI: https://doi.org/10.1007/s10597-006-9049-4
Bendall S, Eastwood O, Cox G, arrelly-Rosch A, Nicoll H, Peters W, et al. A systematic review and synthesis of trauma-informed care within outpatient and counseling health settings for young people. Child Maltreat. 2021;26:313-24. doi:10.1177/1077559520927468. DOI: https://doi.org/10.1177/1077559520927468
Brand RM, McEnery C, Rossell S, Bendall S, Thomas N. Do trauma-focussed psychological interventions have an effect on psychotic symptoms? A systematic review and meta-analysis. Schizophr Res. 2018;195:13-22. doi:10.1016/j.schres.2017.08.037. DOI: https://doi.org/10.1016/j.schres.2017.08.037
Mueser KT, Rosenberg SD, Xie H, Jankowski MK, Bolton EE, Lu W, et al. A randomized controlled trial of cognitive-behavioral treatment for posttraumatic stress disorder in severe mental illness. J Consult Clin Psychol. 2008;76:259-71. doi:10.1037/0022-006X.76.2.259. DOI: https://doi.org/10.1037/0022-006X.76.2.259
Frueh BC, Grubaugh AL, Cusack KJ, Kimble MO, Elhai JD, Knapp RG. Exposure-based cognitive-behavioral treatment of PTSD in adults with schizophrenia or schizoaffective disorder: a pilot study. J Anxiety Disord. 2009;23:665-75. doi:10.1016/j.janxdis.2009.02.005. DOI: https://doi.org/10.1016/j.janxdis.2009.02.005
van den Berg DP, van der Gaag M. Treating trauma in psychosis with EMDR: a pilot study. J Behav Ther Exp Psychiatry. 2012;43:664-671. doi:10.1016/j.jbtep.2011.09.011. DOI: https://doi.org/10.1016/j.jbtep.2011.09.011
Steel C, Hardy A, Smith B, Wykes T, Rose S, Enright S, et al. Cognitive-behaviour therapy for post-traumatic stress in schizophrenia. A randomized controlled trial. Psychol Med. 2017;47:43-51. doi:10.1017/S0033291716002117. DOI: https://doi.org/10.1017/S0033291716002117
Steckler T, Risbrough V. Pharmacological treatment of PTSD - established and new approaches. Neuropharmacology. 2012;62:617-27. doi:10.1016/j.neuropharm.2011.06.012. DOI: https://doi.org/10.1016/j.neuropharm.2011.06.012
Swan S, Keen N, Reynolds N, Onwumere J. Psychological interventions for post-traumatic stress symptoms in psychosis: a systematic review of outcomes. Front Psychol. 2017;8:341. doi:10.3389/fpsyg.2017.00341. DOI: https://doi.org/10.3389/fpsyg.2017.00341
Cloitre M, Garvert DW, Brewin CR, Bryant RA, Maercker A. Evidence for proposed ICD-11 PTSD and complex PTSD: a latent profile analysis. Eur J Psychotraumatol. 2013;4:10. doi:10.3402/ejpt.v4i0.20706. DOI: https://doi.org/10.3402/ejpt.v4i0.20706
Hardy A. Pathways from trauma to psychotic experiences: a theoretically informed model of post-traumatic stress in psychosis. Front Psychol. 2017;8:697. doi:10.3389/fpsyg.2017.00697. DOI: https://doi.org/10.3389/fpsyg.2017.00697
Abregu-Crespo R, Garriz-Luis A, Ayora M, Martin-Martinez N, Cavone V, Carrasco M, et al. School bullying in children and adolescents with neurodevelopmental and psychiatric conditions: a systematic review and meta-analysis. Lancet Child Adolesc Health. 2024;8:122-34. doi:10.1016/S2352-4642(23)00289-4. DOI: https://doi.org/10.1016/S2352-4642(23)00289-4
Kelleher I, Keeley H, Corcoran P, Ramsay H, Wasserman C, Carli V, et al. Childhood trauma and psychosis in a prospective cohort study: cause, effect, and directionality. Am J Psychiatry. 2013;170:734-41. doi:10.1176/appi.ajp.2012.12091169. DOI: https://doi.org/10.1176/appi.ajp.2012.12091169
van Dam DS, van der Ven E, Velthorst E, Selten JP, Morgan C, de Haan L. Childhood bullying and the association with psychosis in non-clinical and clinical samples: a review and meta-analysis. Psychol Med. 2012;42:2463-74. doi:10.1017/S0033291712000360. DOI: https://doi.org/10.1017/S0033291712000360





