Comorbid: Posttraumatic stress disorder and schizophrenia

The treatment of PTSD and schizophrenia remains complex and understudied. A comprehensive treatment approach is essential when one treatment modality is not helpful. In some cases, certain forms of psychosocial interventions succeed when pharmacotherapy is less successful. Recovery must include mutual collaboration and respect between client and therapist, as well as the development and maintenance of a strong therapeutic alliance to address attachment and empowerment issues in treatment. Discharge resistance needs to be reframed to consider the environment into which the patient will be discharged. A person returning to the same neighborhood of the initial traumatization can be expected to experience retraumatization upon discharge. In addition, complicated family dynamics need to be addressed in order to develop a sufficiently supportive environment and ensure successful re-integration into the community. Recognition of the severity of traumatic experiences and the comorbidity of PTSD in people with schizophrenia requires careful assessment and informed interventions. Research must provide detailed descriptions of positive and negative symptoms and dissociative and PTSD symptoms, as well as analyze their overlap. Only careful examination of the correlation of symptoms, rather than classification of symptoms to fit into specific diagnostic categories, will lead to better understanding, accurate diagnosis, and more effective treatment of comorbid disorders.