Hong Wang Fung, Wai Tong Chien
Alpha Psychiatry - 2026;27(3):46069-46069
Psychosis is a significant public health concern and a clinical challenge. However, some psychotic(-like) symptoms or phenomena may be better explained by trauma-related dissociative processes. In such cases, the clinical implications are significant, as trauma-related dissociation requires treatments that are different from those for genuine psychosis. Recent clinical research evidence has suggested that there are at least five important facts about the relationship between psychosis and trauma-related dissociative processes. They include: (a) individuals with dissociative identity disorder report statistically significantly more positive symptoms (of psychosis) than do those with schizophrenia; (b) positive symptoms such as auditory verbal hallucinations are common in people with complex dissociative disorders; (c) the relationship between psychosis and dissociation is obvious - as revealed in a meta-analysis, there is a robust relationship between dissociation and positive psychotic symptoms across clinical and nonclinical studies; (d) psychotic symptoms may be predicted by dissociation and its symptoms; and, (e) unrecognized trauma and dissociation are common in people with a psychotic disorder. Some people who have psychotic disorders may actually have dissociation; and it is sometimes referred to as dissociative psychosis, although this condition has not been officially recognized in diagnostic manuals.
