SMI Research Digest: Psychosis Causes, Risks, and Evidence-Based Care

SMI Research Digest is a monthly publication from TAC’s Public Education and Research (PER) team that summarizes recently published research on topics related to severe mental illness (SMI). This month, we examine advances in understanding and treating psychosis including immunotherapy, trauma-focused treatment, and traumatic brain injury.

Immunotherapy improves symptoms for people with autoimmune psychosis. Autoimmune diseases have been estimated to cause 3-9% of all first-episode psychosis cases. In a July 2025 study from Schizophrenia Research, researchers screened patients with psychosis and gave immunotherapy to patients whose psychotic symptoms were probably or definitely caused by an autoimmune disease. After receiving immunotherapy, patients experienced significant reductions in hallucinations, delusions, and negative symptoms, as well as improvements in cognition and functioning. Almost 40% of patients in this study were misdiagnosed with a psychiatric disorder like schizophrenia before being correctly diagnosed with autoimmune disease. Patients with autoimmune psychosis also saw no improvement or worsening symptoms after receiving antipsychotic medication, emphasizing the importance of correct identification and treatment for autoimmune psychosis.

Trauma-focused treatment improves psychosis and trauma symptoms. People with psychosis experience high rates of trauma. This trauma can be caused by symptoms like hallucinations, situations linked to psychotic symptoms like arrest or victimization, or can occur before the onset of symptoms such as with trauma experienced in childhood. Despite the elevated risk of trauma exposure, trauma-focused treatments are often not provided to people with psychosis. A systematic review from Early Intervention in Psychiatry recently explored the effectiveness of trauma-focused treatments on people with psychosis across 17 studies. This review found that trauma-focused treatments like cognitive behavioral therapy (CBT), eye movement desensitization and reprocessing (EMDR), and prolonged exposure (PE) were effective at reducing trauma symptoms like intrusive thoughts and disassociation, as well as psychosis symptoms. The authors state that their review suggests these trauma-focused interventions can be safe and effective for people who experience psychosis.

Traumatic brain injury (TBI) is a risk factor for schizophrenia and bipolar disorder. A recent study from Psychiatry Research sought to explore the relationship between traumatic brain injury and severe mental illness by looking at the medical histories of over 4,000 people with schizophrenia and over 18,000 people with bipolar disorder. The authors found that a history of TBI was associated with a 33% increase in the risk of being diagnosed with schizophrenia and a 78% increase in the risk of being diagnosed with bipolar disorder. The more severe the TBI, the higher the risk was of developing SMI. The authors note that these results do not prove that traumatic brain injury causes SMI, but that these findings should prompt health care providers to monitor potential psychiatric symptoms in people with a history of TBI.   

​​​​​SMI Research Digest is a monthly public service by TAC that highlights new, impactful research on topics related to severe mental illness. ​​​​​​If you would like to support TAC programs and publications please consider making a donation today.