Defining Psychosis in PTSD

Letter to the Editor

Sir: David et al. (January 1999 issue) provide important data on the prevalence of hallucinations and delusions in patients with combat-related posttraumatic stress disorder (PTSD). Of the 53 patients studied, 21 (40%) are said to have shown "psychotic" symptoms, of which auditory hallucinations were the most common (95% of cases). Hallucinatory experiences were considered psychotic "if they were not accompanied by the perception of being back in the traumatic situation (i.e., flashbacks) and if there was at least momentary disturbance in reality testing (i.e., behavioral response to hearing voices, experiencing voices as ‘ real’ )."