Enquiring about traumatic experiences in psychosis: A comparison of case notes and self-report questionnaires

Purpose: Studies have found an association between a history of trauma and the presence of psychotic symptoms. Despite the research evidence it appears to be the case that many clinicians are not routinely asking about traumatic experiences. This study aims to ascertain the level of agreement between rates of self-reported trauma and that which is recorded in case notes.

Methods: The study population was drawn from all individuals with a confirmed diagnosis of psychosis, residing within a defined catchment area. Rates of childhood trauma, lifetime trauma and trauma related to the Troubles in Northern Ireland recorded in participants’ case notes were compared to their responses on self-report questionnaires: THQ, CTQ and TREQ.

Results: Relatively high levels of trauma were reported by participants on the self-report measures that were administered. The rates of trauma recorded in case note records were similar to that found in other studies. Also in line with other research were poor levels of agreement between self-report and case note data.

Conclusion: High levels of lifetime, childhood and trauma related to the Troubles in Northern Ireland were found when the individuals in the sample were directly assessed for the purposes of this study. In contrast much lower rates were recorded in patient notes on routine clinical assessment. The results suggest that clinicians do not routinely enquire about trauma histories with this population and as a result, case notes underestimate trauma prevalence.

A survey of Australian human services agency software usage

Human Services agencies use a wide range of software systems to manage caseloads, maintain records, deliver services to clients, and for interagency communication. Some systems are generic, such as Word or Excel, while some are specialized to the organization, such as specialized databases for tracking case notes. Some software systems are shared across organizations. We surveyed nearly 40 Australian Human Services agencies to ascertain the range of software currently in use by agencies and their opinions on it, with a view to identifying promising new Human Services applications. We interviewed representatives from a selection of smaller agencies. This resulted in detailed feedback on key issues to consider when developing and deploying new Human Services software.