Rationale:

• Many PTSD symptoms overlap with mood and anxiety disorders.
• The sensory experiences (e.g., flashbacks) and hypervigilance of PTSD can be easily confused with psychotic symptoms such as hallucinations and paranoid delusions.

Evidence:

• Traumatic stressors can precipitate depressive and anxiety disorders with or without comorbid PTSD. Patients with psychotic disorders may experience traumatic stressors, which may exacerbate a preexisting illness. Psychotic disorders are not commonly caused by these events. The relationships between childhood trauma, personality disorders, and PTSD are complex and incompletely understood (1; 2; 3; 7; 8; 9).

Comments:

• The key feature of PTSD is the multiplicity of symptoms. Patients who do not have at least three types of posttraumatic stress symptoms (see table Simplified Diagnostic Criteria for Posttraumatic Stress Disorder) may have another mood or anxiety disorder.