In psychiatric studies, trauma and psychosis have long been linked, although researchers have not been able to establish a unilateral cause-and-effect relationship. While clinical research in psychiatry has focused on the prevention of psychotic decompensation, and even on the identification of pre-psychotic states in adolescents – not without caution, however, due to the stigma associated with the diagnosis of psychotic pathologies –, in the everyday clinical practice psychiatrists and psychologists are faced with psychopathological configurations in which the distinction between post-traumatic states and psychotic symptoms proves to be equivocal. This results in doubts as to the diagnosis and the future of the young people who are treated for such disorders. The difference between hallucinations and reliving a traumatic experience, for example, can mislead the clinician about the subjective structure of the adolescent and thus contribute to a very marked orientation of the treatment either towards subjective reconstruction based on the damage induced by the traumatic events, or towards the avoidance of possible psychotic decompensation. After conducting an overview of the scientific literature on the interactions between traumatic/traumatogenic experiences and psychotic-type symptoms, we will consider five case studies of adolescents with traumatic life histories and who have been hospitalized for acute or subacute psychotic-like disorders. The methodology for our analyses will be qualitative, so that it can help the clinician to distinguish between apparently similar clinical ensembles, and in order to better articulate the points of uncertainty and the elements of differential diagnosis between brief psychotic disorders related to complex traumas and the potential decompensation of a more chronic psychotic disorder, e.g., schizophrenia. In the case of complex traumas, we propose to shift the focus away from a search for pre-psychotic symptoms in order to prevent the decompensation of a supposed chronic psychosis, and to consider instead the delusions and hallucinations experienced by these subjects as transitory symptoms in adolescence, which are extreme defense mechanisms against traumatic life events. Beyond the question of the endogenous or exogenous nature of the symptoms, we will discuss the type of care provided to these young people, in order to adapt the treatment and avoid making these disorders worse during adulthood. The future of these young people depends on an accurate and non-stigmatizing diagnosis.