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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: [email protected])
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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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