The effectiveness and tolerability of trauma-focused psychotherapies for psychotic symptoms: A systematic review of trauma-focused psychotherapies

Int J Methods Psychiatr Res. 2024 Mar;33(1):e2005. doi: 10.1002/mpr.2005.

Abstract

Introduction: Psychological trauma is an established risk factor for psychosis. Trauma-focused psychotherapies (TFPT) have been suggested as a potential treatment for reducing psychotic symptoms in those who have experienced trauma. We therefore sought to investigate the effectiveness, tolerability, and acceptability of TFPT for psychotic symptoms.

Methods: We conducted a systematic review of studies of any form of TFPT that measured psychotic symptoms across a broad range of diagnoses.

Results: From 2584 papers initially identified, 17 studies (857 participants) met eligibility criteria. TFPT were found to be well tolerated, with very few adverse events. Acceptability was also high, with a mean dropout rate of 20%.

Conclusions: Whilst the evidence of effectiveness for TFPT in reducing psychotic symptoms is weak, we found tentative evidence in favour of exposure-based interventions. Methodologically rigorous trials investigating the efficacy of TFPT for the treatment of psychotic symptoms are needed to assess this promising intervention.

Keywords: PTSD; psychosis; psychotherapy; schizophrenia; trauma.

Publication types

  • Systematic Review

MeSH terms

  • Humans
  • Psychological Trauma* / therapy
  • Psychotherapy
  • Psychotic Disorders* / therapy
  • Risk Factors