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Auditory verbal hallucinations in patients with borderline personality disorder are similar to those in schizophrenia

Published online by Cambridge University Press:  16 February 2012

C. W. Slotema ,
K. Daalman ,
J. D. Blom ,
K. M. Diederen ,
H. W. Hoek  and
I. E. C. Sommer
C. W. Slotema*
Affiliation:
Parnassia Bavo Psychiatric Institute, The Hague, The Netherlands
K. Daalman
Affiliation:
Department of Psychiatry & Rudolf Magnus Institute for Neuroscience, University Medical Centre Utrecht, The Netherlands
J. D. Blom
Affiliation:
Parnassia Bavo Psychiatric Institute, The Hague, The Netherlands
K. M. Diederen
Affiliation:
Department of Psychiatry & Rudolf Magnus Institute for Neuroscience, University Medical Centre Utrecht, The Netherlands
H. W. Hoek
Affiliation:
Parnassia Bavo Psychiatric Institute, The Hague, The Netherlands Department of Psychiatry, University Medical Centre Groningen, University of Groningen, The Netherlands Department of Epidemiology, Columbia University, New York, NY, USA
I. E. C. Sommer
Affiliation:
Department of Psychiatry & Rudolf Magnus Institute for Neuroscience, University Medical Centre Utrecht, The Netherlands
*
*Address for correspondence: Dr C. W. Slotema, Parnassia Bavo Psychiatric Institute, Lijnbaan 4, 2512 VA, The Hague, The Netherlands. (Email: c.slotema@psyq.nl)
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Abstract

Background

Auditory verbal hallucinations (AVH) in patients with borderline personality disorder (BPD) are frequently claimed to be brief, less severe and qualitatively different from those in schizophrenia, hence the term ‘pseudohallucinations’. AVH in BPD may be more similar to those experienced by healthy individuals, who experience AVH in a lower frequency and with a more positive content than AVH in schizophrenia. In this study the phenomenology of AVH in BPD patients was compared to that in schizophrenia and to AVH experienced by non-patients.

Method

In a cross-sectional setting, the phenomenological characteristics of AVH in 38 BPD patients were compared to those in 51 patients with schizophrenia/schizoaffective disorder and to AVH of 66 non-patients, using the Psychotic Symptom Rating Scales (PSYRATS).

Results

BPD patients experienced AVH for a mean duration of 18 years, with a mean frequency of at least daily lasting several minutes or more. The ensuing distress was high. No differences in the phenomenological characteristics of AVH were revealed among patients diagnosed with BPD and those with schizophrenia/schizoaffective disorder, except for ‘disruption of life’, which was higher in the latter group. Compared to non-patients experiencing AVH, BPD patients had higher scores on almost all items.

Conclusions

AVH in BPD patients are phenomenologically similar to those in schizophrenia, and different from those in healthy individuals. As AVH in patients with BPD fulfil the criteria of hallucinations proper, we prefer the term AVH over ‘pseudohallucinations’, so as to prevent trivialization and to promote adequate diagnosis and treatment.

Keywords

Auditory verbal hallucinationsborderline personality disorderschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 9 , September 2012 , pp. 1873 - 1878
Copyright
Copyright © Cambridge University Press 2012

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References

Andreasen, NC, Flaum, M, Arndt, S (1992). The Comprehensive Assessment of Symptoms and History (CASH). An instrument for assessing diagnosis and psychopathology. Archives of General Psychiatry 49, 615–623.CrossRefGoogle ScholarPubMed
APA (1987). Diagnostic and Statistical Manual of Mental Disorders: DSM-III-R (3rd edn revised). American Psychiatric Association: Washington, D.C.Google Scholar
APA (1994). Diagnostic and Statistical Manual of Mental Disorders (4th edition). American Psychiatric Association: Washington, D.C. Google Scholar
APA (2000). Diagnostic and Statistical Manual of Mental Disorders (4th edn, text revision). DSM-IV-TR. American Psychiatric Association: Washington, D.C. Google Scholar
Chopra, HD, Beatson, JA (1986). Psychotic symptoms in borderline personality disorder. American Journal of Psychiatry 143, 1605–1607.Google ScholarPubMed
Daalman, K, Boks, MP, Diederen, KM, de Weijer, AD, Blom, JD, Kahn, RS, Sommer, IE (2011). The same or different? a phenomenological comparison of auditory verbal hallucinations in healthy and psychotic individuals. Journal of Clinical Psychiatry 72, 320–325.CrossRefGoogle ScholarPubMed
George, A, Soloff, PH (1986). Schizotypal symptoms in patients with borderline personality disorders. American Journal of Psychiatry 143, 212–215.Google ScholarPubMed
Glaser, JP, Van Os, J, Thewissen, V, Myin-Germeys, I (2010). Psychotic reactivity in borderline personality disorder. Acta Psychiatrica Scandinavica 121, 125–134.CrossRefGoogle ScholarPubMed
Haddock, G, McCarron, J, Tarrier, N, Faragher, EB (1999). Scales to measure dimensions of hallucinations and delusions: the psychotic symptom rating scales (PSYRATS). Psychological Medicine 29, 879–889.CrossRefGoogle ScholarPubMed
Heins, T, Gray, A, Tennant, M (1990). Persisting hallucinations following childhood sexual abuse. Australian and New Zealand Journal of Psychiatry 24, 561–565.CrossRefGoogle ScholarPubMed
Hoch, P, Polatin, P (1949). Pseudoneurotic forms of schizophrenia. Psychiatric Quarterly 23, 248–76.CrossRefGoogle ScholarPubMed
Kingdon, DG, Ashcroft, K, Bhandari, B, Gleeson, S, Warikoo, N, Symons, M, Taylor, L, Lucas, E, Mahendra, R, Ghosh, S, Mason, A, Badrakalimuthu, R, Hepworth, C, Read, J, Mehta, R (2010). Schizophrenia and borderline personality disorder: similarities and differences in the experience of auditory hallucinations, paranoia, and childhood trauma. Journal of Nervous and Mental Disease 198, 399–403.CrossRefGoogle ScholarPubMed
Korzekwa, MI, Dell, PF, Links, PS, Thabane, L, Webb, SP (2008). Estimating the prevalence of borderline personality disorder in psychiatric outpatients using a two-phase procedure. Comprehensive Psychiatry 49, 380–386.CrossRefGoogle ScholarPubMed
Laroi, F, Marczewski, P, Van der Linden, M (2004). Further evidence of the multi-dimensionality of hallucinatory predisposition: factor structure of a modified version of the Launay-Slade Hallucinations Scale in a normal sample. European Psychiatry 19, 15–20.CrossRefGoogle Scholar
Lotterman, AC (1985). Prolonged psychotic states in borderline personality disorder. Psychiatric Quarterly 57, 33–46.CrossRefGoogle ScholarPubMed
Maffei, C, Fossati, A, Agostoni, I, Barraco, A, Bagnato, M, Deborah, D, Namia, C, Novella, L, Petrachi, M (1997). Interrater reliability and internal consistency of the structured clinical interview for DSM-IV axis II personality disorders (SCID-II), version 2.0. Journal of Personality Disorders 11, 279–284.CrossRefGoogle ScholarPubMed
Pope, HG Jr., Jonas, JM, Hudson, JI, Cohen, BM, Tohen, M (1985). An empirical study of psychosis in borderline personality disorder. American Journal of Psychiatry 142, 1285–1290.Google ScholarPubMed
Skodol, AE, Gunderson, JG, Pfohl, B, Widiger, TA, Livesley, WJ, Siever, LJ (2002). The borderline diagnosis I: psychopathology, comorbidity, and personality structure. Biological Psychiatry 51, 936–950.CrossRefGoogle ScholarPubMed
Soloff, PH (1979). Physical restraint and the nonpsychotic patient: clinical and legal perspectives. Journal of Clinical Psychiatry 40, 302–305.Google ScholarPubMed
Sommer, IE, Daalman, K, Rietkerk, T, Diederen, KM, Bakker, S, Wijkstra, J, Boks, MP (2010). Healthy individuals with auditory verbal hallucinations; who are they? Psychiatric assessments of a selected sample of 103 subjects. Schizophrenia Bulletin 36, 633–641.CrossRefGoogle ScholarPubMed
Yee, L, Korner, AJ, McSwiggan, S, Meares, RA, Stevenson, J (2005). Persistent hallucinosis in borderline personality disorder. Comprehensive Psychiatry 46, 147–154.CrossRefGoogle ScholarPubMed
Zanarini, MC, Gunderson, JG, Frankenburg, FR (1990). Cognitive features of borderline personality disorder. American Journal of Psychiatry 147, 57–63.Google ScholarPubMed