Prevalence of interpersonal trauma exposure and trauma-related disorders in severe mental illness

Maria W Mauritz, Peter J J Goossens, Nel Draijer, Theo van Achterberg, Maria W Mauritz, Peter J J Goossens, Nel Draijer, Theo van Achterberg

Abstract

Background: Interpersonal trauma exposure and trauma-related disorders in people with severe mental illness (SMI) are often not recognized in clinical practice.

Objective: To substantiate the prevalence of interpersonal trauma exposure and trauma-related disorders in people with SMI.

Methods: We conducted a systematic review of four databases (1980-2010) and then described and analysed 33 studies in terms of primary diagnosis and instruments used to measure trauma exposure and trauma-related disorders.

Results: Population-weighted mean prevalence rates in SMI were physical abuse 47% (range 25-72%), sexual abuse 37% (range 24-49%), and posttraumatic stress disorder (PTSD) 30% (range 20-47%). Compared to men, women showed a higher prevalence of sexual abuse in schizophrenia spectrum disorder, bipolar disorder, and mixed diagnosis groups labelled as having SMI.

Conclusions: Prevalence rates of interpersonal trauma and trauma-related disorders were significantly higher in SMI than in the general population. Emotional abuse and neglect, physical neglect, complex PTSD, and dissociative disorders have been scarcely examined in SMI.

Keywords: Childhood trauma; complex posttraumatic stress disorder; dissociative disorder; emotional abuse; neglect; physical abuse; posttraumatic stress disorder; severe mental illness; sexual abuse.

Figures

Fig. 1
Fig. 1
Selection in scheme.
Fig. 2
Fig. 2
Prevalence rates for physical abuse, sexual abuse, and PTSD by disorder and reference period. BD, bipolar disorder; MDD, major depressive disorder; SSD, schizophrenia spectrum disorder; SMI, severe mental illness; B, borderline; ST, schizotypal; AV, avoidant; OC, obsessive compulsive (personality disorder).
Fig. 3
Fig. 3
Overview of mean prevalence of physical abuse, sexual abuse, and PTSD by diagnostic group.
Fig. 4
Fig. 4
Prevalence rates for physical abuse, sexual abuse, and PTSD by disorder and gender. BD, bipolar disorder; SSD, schizophrenia spectrum disorder; SMI, severe mental illness.

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