Psychotic symptoms in patients with borderline personality disorder

TY - JOUR

T1 - Psychotic symptoms in patients with borderline personality disorder

T2 - prevalence and clinical management

AU - Schroeder, Katrin

AU - Fisher, Helen L

AU - Schäfer, Ingo

PY - 2013/1/1

Y1 - 2013/1/1

N2 - PURPOSE OF REVIEW: The aim of this article is to review findings on the prevalence, phenomenology and treatment of psychotic features in borderline personality disorder (BPD), and to discuss factors that might be related to their occurrence.RECENT FINDINGS: Of patients with BPD about 20-50% report psychotic symptoms. Hallucinations can be similar to those in patients with psychotic disorders in terms of phenomenology, emotional impact, and their persistence over time. Although more research is needed on the exact nature of psychotic phenomena in patients with BPD, terms like pseudo-psychotic or quasi-psychotic are misleading and should be avoided. Childhood trauma might play an important role in the development of psychotic symptoms in patients with BPD, as in other populations. More research is necessary on the role of comorbid disorders, especially posttraumatic stress disorder (PTSD). Atypical antipsychotics seem to be beneficial in some patients; evidence on psychotherapy of psychotic symptoms is sparse.SUMMARY: Psychotic symptoms, especially hallucinations, seem to be an important feature of BPD. More research on potential mediators and adequate treatment approaches for psychotic symptoms in BPD is needed, and current diagnostic systems might require revision to emphasise psychotic symptoms.

AB - PURPOSE OF REVIEW: The aim of this article is to review findings on the prevalence, phenomenology and treatment of psychotic features in borderline personality disorder (BPD), and to discuss factors that might be related to their occurrence.RECENT FINDINGS: Of patients with BPD about 20-50% report psychotic symptoms. Hallucinations can be similar to those in patients with psychotic disorders in terms of phenomenology, emotional impact, and their persistence over time. Although more research is needed on the exact nature of psychotic phenomena in patients with BPD, terms like pseudo-psychotic or quasi-psychotic are misleading and should be avoided. Childhood trauma might play an important role in the development of psychotic symptoms in patients with BPD, as in other populations. More research is necessary on the role of comorbid disorders, especially posttraumatic stress disorder (PTSD). Atypical antipsychotics seem to be beneficial in some patients; evidence on psychotherapy of psychotic symptoms is sparse.SUMMARY: Psychotic symptoms, especially hallucinations, seem to be an important feature of BPD. More research on potential mediators and adequate treatment approaches for psychotic symptoms in BPD is needed, and current diagnostic systems might require revision to emphasise psychotic symptoms.

KW - Antipsychotic Agents

KW - Borderline Personality Disorder

KW - Comorbidity

KW - Humans

KW - Psychotherapy

KW - Psychotic Disorders

KW - Stress Disorders, Post-Traumatic

U2 - 10.1097/YCO.0b013e32835a2ae7

DO - 10.1097/YCO.0b013e32835a2ae7

M3 - SCORING: Journal article

C2 - 23168909

VL - 26

SP - 113

EP - 119

JO - CURR OPIN PSYCHIATR

JF - CURR OPIN PSYCHIATR

SN - 0951-7367

IS - 1

ER -