It is conceptualized as an emotion-regulation disorder ( 17), characterized by unstable relationships, identity disturbances, and self-destructive behavior. BPD is a severe psychiatric disorder with a lifetime prevalence rate of 1–3% in the general population ( 15, 16). Although less well-known, AVH are experienced in the context of borderline personality disorder (BPD) as well ( 10, 13, 14). In these patients they tend to also yield high levels of distress which may lead to destructive behavior, such as suicide and homicide ( 11, 12). The highest prevalence of these phenomena is in patients diagnosed with schizophrenia. The efficacy of cognitive-behavioral therapy and non-invasive brain stimulation has not yet been systematically assessed.Ĭonclusions: These findings indicate that AVH experienced in the context of BPD are in need of proper diagnosis and treatment, and that antipsychotics tend to be beneficial in treating these (and other psychotic) symptoms.There is an urgent need for studies assessing the efficacy of cognitive-behavioral therapy and non-invasive brain stimulation in this underdiagnosed and undertreated group.Īuditory verbal hallucinations (AVH) are voices perceived during wakefulness, in the absence of an external origin ( 9). Based on these studies, we conclude that both typical and atypical antipsychotics tend to have positive effects on AVH experienced in the context of BPD. The efficacy of antipsychotics was investigated in 21 studies. Moreover, AVH in the context of BPD were associated with higher prevalence rates for post-traumatic stress disorder and emotional abuse. The presence of AVH in BPD was associated with an increase of suicide plans and attempts, and more frequent hospitalization. Compared to patients with schizophrenia, the phenomenological characteristics of AVH were similar and the ensuing distress was equal or even higher, whereas scores for other positive symptoms were lower. On the whole, patients with BPD regarded their voices as malevolent and omnipotent in nature. Of the hallucinating patients, 78% experienced AVH at least once per day, for a duration of several days to many years. Auditory hallucinations (including AVH) were reported in 27% of hospitalized BPD patients AVH were reported in 25% of all patients and in 24% of outpatients. Results: The search yielded 36 studies describing a total of 1,263 patients. Methods: For this review a systematic search was made in the PubMed and Ovid databases, and mean weighted prevalence rates, adjusted for sample size, were computed. Objective: To provide a systematic review of studies reporting on AVH in patients with BPD, with a focus on the efficacy of treatment of psychotic symptoms. However, consensus is lacking on how to treat them.
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