1.2 Trauma, Psychosis and Clinical Practice
Although populations experiencing psychosis have been found to have higher rates of childhood victimisation and PTSD than the general population (Conus et al., 2007; Kessler et al., 2005; Kraan et al., 2015; Steel et al., 2017), a study by Neill and Read (2022) investigating the documentation of trauma in community mental health services in England found that 87% of assessments in clinical records contained no documentation of trauma experienced by patients being treated for psychosis. The disparity between the research evidence for the relationship between trauma and psychosis and clinical practice emphasised that a trauma-focused approach had not become routine clinical practice. Staff may not be inquiring about trauma, patients may not be disclosing trauma exposures, or the sequalae of potentially traumatic events gleaned in narrative histories may not be the subject of more detailed inquiry.
A further consideration is that in recent years, many people may have had an increased risk of trauma-exposure due to their experiences during the COVID-19 pandemic (Kaubisch et al., 2022; Delz et al., 2023). Due to the recency of these events, it is unclear whether the COVID-19 pandemic may have impacted on psychosis presentations in the community and the detection of this putative pathway may be hampered by limited systematic enquiry of trauma symptomatology in clinical histories.