Exploring Complex PTSD and Psychosis

Scientific research on cptsd

Interesting stuff coming out of the UK about Complex PTSD.

The North West United Kingdom mental health services conducted a unique study looking into the relationship of trauma, particularly complex trauma, with psychosis.

In short, they had 144 people who suffer from psychosis answer questions. The questions were designed to help assess the trauma the person suffered, the prevalence of PTSD and Complex-PTSD symptoms, as well as their symptoms of psychosis.

What the researchers found was –
10% of the study participants suffered from PTSD, but 40% of the sample suffered from cPTSD.

That in itself is a remarkable finding, but wait, there’s more.

The following sentence from the summary carries more meaning than you might initialy attatch to it.

PTSD and DSOs mediated the relationship between trauma and positive symptoms, controlling for dataset membership.

Let’s start with the definition of ‘positive symptoms’ –
In psychology ‘positive symptoms’ are defined as : highly exaggerated ideas, perceptions, or actions that show the person can’t tell what’s real from what isn’t. Here the word “positive” means the presence of symptoms. Which, in itself is not a positive thing. (Sorry, couldn’t resist the word play.)

The second term to parse out is DSOs. This is short hand for ‘disturbances in self-organization’ (DSOs) – which is a recognized attribute of Complex-PTSD in the International Classification of Diseases-11th Edition. Thank you Europe. You are so far ahead of the DSM.

Putting those terms together the sentence is telling us that PTSD and DSOs (aka cPTSD) were present in people who had suffered trauma and were now suffering psychosis. In addition there was also a relationship to exist between cPTSD and affective disorders (illnesses that affect the way a person thinks and feels).  

However, the relationship did not carry over to explain significant differences in the presence of negative sypmtoms. Remember, a ‘negative symptom’ doesn’t mean that there isn’t a problem. In psychology, a negative symptom denotes a loss of something. Negative symptoms include the inability to show emotions, apathy, difficulties talking, and withdrawing from social situations and relationships.

The summary of the article includes two important sentences:
1. Traumatic experiences and post-traumatic stress are highly prevalent in people with psychosis, increasing symptom burden, decreasing quality of life and moderating treatment response.
2. The prevalence and impact of cPTSD and DSOs in psychosis remains to be explored.

So, what I’m reading here is that trauma that results in cPTSD does have some linkage to some symptoms of psychosis. BUT, we don’t know what that particular mechanism is yet.

They end the study summary with this line: “These findings indicate the possible value of adjunct therapies to manage cPTSD symptoms in people with psychosis, pending replication in larger epidemiological samples and longitudinal studies.”

In other words – people who suffer from psychosis might also benefit from therapies for cPTSD — as long as a future study doesn’t toss all this in the proverbial bin.

The Role and Clinical Correlates of Complex Post-traumatic Stress Disorder in People With Psychosis [https://www.frontiersin.org/articles/10.3389/fpsyg.2022.791996/full]

Research: Brain Activity Patterns After Trauma

Scientific research on cptsd

From October 2021 – The U.S. National Institutes of Health reported on a study that might demonstrate a link between post-trauma brain activity and symptoms of anxiety and PTSD.

The study doesn’t directly address the long term factors that contribute to Complex PTSD. Instead the study focuses on short-term instances of trauma, single event situations. Still, the information might allow researchers to being to detect the mental activity patterns that are prevalent in Complex PTSD. That could lead to a discernable physical marker for diagnosis?

Brain activity patterns after trauma may predict long-term mental health

Good News on Psilocybin for Major Depression

Scientific research on cptsd

Not that anyone following me on Twitter will be surprised to hear this – but – in case you haven’t, there is research coming out of Johns Hopkins Medicine that is good news for sufferers of major depression.

From the article –

The findings of a small study of adults with major depression, published Nov. 4, 2020, in JAMA Psychiatry, suggest that psilocybin may prove effective in a larger population of patients with intractable depression than previously appreciated.

This is great news. Do remember that it is only a very small study. Only 24 participants. But, the findings mean that there could be more trials and greater acceptance (and knowledge) of using psilocybin to treat major depression.

Griffiths and his colleagues reported that two doses of psilocybin during medically supervised treatment — supplemented by supportive psychotherapy — produced rapid and large reductions in depressive symptoms.

Milestone Study Shows Psychedelic Treatment with Psilocybin Relieves Major Depression

New class of antidepressants?

Scientific research on cptsd

Source C&E News February 7, 2022

How do you know if a mouse is hallucinating?

Apparently mice on LSD and psilocybin twich their heads. Fascinating. But then, if I was a mouse and my world had gone all psychotropic I suspect there would be some head twitching, too.

So what do tripping mice have to do with Complex PTSD?

As many readers may already know LSD and psilocybin are two controlled substances that have been demonstraated to help alleviate mood disorders. In light of CPTSD these mood disorders may include depression, major depression, persistent depression and psychotic depression. (yes, we are such a fun bunch. </sarcasm>)

Why do these drugs help with Complex PTSD?

The simple answer is ‘brain chemistry’.

The longer answer goes like this:
There is a receptor in the central nervous system called 5-HT2A. This receptor is where serotonin binds to the cell. Serotonin in the brain is linked with mood, anxiety regulation, sexuality, memory, and some social fascets. In essence, your brain is bathing in serotonin. This is why SSRI – Selective Serotonin Reuptake Inhibitors – class drugs are often prescribed to people with symptoms of depression.
Simple logic – raise the level of serotonin in the brain –> lower the presence of depression symptoms.

Guess what else binds to 5-HT2A. If you said magic mushrooms (psilocybin) and LSD you are correct.

However, these drugs also induce hallucinations. Psilocybin is “a Schedule I controlled substance because it has no approved medical purpose and the potential for abuse.”** LSD is also a Schedule I controlled substance. ***

What scientists are trying to discover is – what is the difference between a compound that binds to 5-HT2A that causes hallucinations vs. one that does not. That discovery will open an area of research into new antidepressive medication. It could also prove valuable for people who need antipsychotic medication.

So far scientists have produced two compounds based on this research that demonstrate antidepressant activity without hallucinations in mice.

There is a long step between the lab and a safe effective human medication. The process can take years. But, there is hope, and growing proof, of a new way to help people who suffer from a chronic imbalance of brain chemistry.

Article is at : Hallucinogen Chemistry Guies Antidepressant Drug Discovery by Bethany Halford
[ https://pubs.acs.org/doi/pdf/10.1021/cen-10005-leadcon ] (Sorry, you need ACS membership.)

**(source: USDA [ https://www.usada.org/spirit-of-sport/magic-mushrooms-prohibited-status/ ] as of Feb. 16, 2022)
***(source: DEA [https://www.dea.gov/drug-information/drug-scheduling] as of Feb 16, 2022)