Experiences of trauma among persons living with psychosis in KwaZulu Natal, South Africa

Existing literature from high-resource settings suggests that exposure to traumatic life events is associated with increased risk for psychosis. Research on how people with psychosis in South Africa perceive and make sense of their past traumatic life events is lacking. This study aimed to understand the lived experiences of persons living with psychosis in KwaZulu-Natal (KZN), South Africa. The study explored how individuals living with psychosis describe and conceptualize their traumatic life experiences and how it impacted them. We used a qualitative narrative research study design. Individual in-depth interviews were conducted in English and/or isiZulu with 19 adult patients with early psychosis who were receiving treatment at provincial hospitals in the eThekwini district in KZN, South Africa (mean age = 28.7±7.6, mostly male (68%) and unemployed (74%)). We analysed transcribed data using interpretive phenomenological analysis. Participants' descriptions of traumatic life experiences included parent-child relationship disruption during their formative years and other adverse events associated with being separated from their parental figures including residential instability, financial hardship, sexual and physical abuse, and peer and community violence. Participants also described the experience of psychosis as a traumatic event. These traumatic experiences led to sense of loss for some participants, while others described post-traumatic stress symptoms including reexperiencing their trauma memories through psychotic episodes. The study provides clinical insight on the experiences of trauma among people with psychosis and highlights the need for adopting a trauma-informed service model in early psychosis care in South Africa.