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Brief Reports   |    
Perceived Trauma During Hospitalization and Treatment Participation Among Individuals With Psychotic Disorders
Diana Paksarian, M.P.H., Ph.D.; Ramin Mojtabai, M.D., Ph.D.; Roman Kotov, Ph.D.; Bernadette Cullen, M.B.B.Ch.; Katie L. Nugent, Ph.D.; Evelyn J. Bromet, Ph.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201200556
View Author and Article Information

Dr. Paksarian, Dr. Mojtabai, and Dr. Cullen are with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (e-mail: dpaksari@jhsph.edu). Dr. Cullen is also with the Department of Psychiatry and Behavioral Health, the Johns Hopkins Medical Institutions, Baltimore. Dr. Kotov and Dr. Bromet are with the Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, New York. Dr. Nugent is with the Department of Psychiatry, University of Maryland School of Medicine, Baltimore.

Copyright © 2014 by the American Psychiatric Association


Objective  This study assessed the association of perceptions of traumatic experiences during psychiatric hospitalizations and treatment participation.

Methods  Participants (N=395) in the Suffolk County Mental Health Project, who had been admitted for the first time for a psychotic disorder ten years earlier, were interviewed. The authors examined associations of perceived trauma and distressing or coercive experiences during hospitalizations in the past ten years with patient characteristics and treatment participation.

Results  Sixty-nine percent of participants reported perceived trauma. Perceived trauma was more common among females versus males and homemakers versus full-time workers. It was not associated with treatment seeking or time in treatment. However, reporting forced medication was associated with reduced time in treatment, especially for persons with schizophrenia spectrum disorders.

Conclusions  Although perceptions of trauma during psychiatric hospitalization were common, they may be unrelated to treatment participation. However, there was modest evidence of a link between coercive experiences and reduced treatment time.

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Table 1Associations of perceived trauma and specific experiences related to hospitalization with time in treatment of ≥75% among patients with a psychotic disordera
Table Footer Note

a Perceived trauma and specific experiences were reported by 395 individuals in relation to hospitalizations that occurred in the ten years since a first admission for psychosis. Time in treatment (available for 298 participants) of ≥75% indicates receipt of any form of treatment for ≥75% of the time during the past ten years. Models were controlled for age, sex, race-ethnicity, and Brief Psychiatric Rating Scale score at ten-year follow-up. For the bipolar subgroup, race-ethnicity was controlled by restricting the analyses to nonblacks because of sparse data.

Table Footer Note

* p<.05, Bonferroni-corrected α=.0056



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