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.