Aripiprazole compared with placebo for auditory verbal hallucinations in youth with borderline personality disorder: Protocol for the VERBATIM randomized controlled trial

Chanen, Andrew M; Betts, Jennifer; Jackson, Henry; McGorry, Patrick D.; Nelson, Barnaby; Cotton, Sue; Bartholomeusz, Cali F.; Jovev, Martina; Ratheesh, Aswin; Davey, Christopher G.; Pantelis, Christos; McCutcheon, Louise; Francey, Shona; Bhaduri, Amit; Lowe, Danielle; Rayner, Victoria; Thompson, Katherine

doi:10.1111/eip.12774

Cited by 9 publications

(3 citation statements)

References 71 publications

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“… 76 The first randomized controlled trial on aripiprazole in young people with BPD and auditory verbal hallucinations is underway. 95 Since negative beliefs about hallucinated voices 96 , 97 and self-image 98 contribute to emotional distress in BPD, hallucinations themselves could become targets for psychological interventions such as cognitive behavioural therapy or narrative-based self-experience interventions (Thomas et al 2014, Fielding-Smith et al 2015). 99 , 100 …”

Section: Discussion and Future Directionsmentioning

confidence: 99%

Hallucinations and Other Psychotic Symptoms in Patients with Borderline Personality Disorder

Minaříková¹,

Praško²,

Holubová³

et al. 2022

NDT

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Background Psychotic symptoms in BPD are not uncommon, and they are diverse and phenomenologically similar to those in schizophrenia spectrum disorders. Despite their prevalence in BPD patients, knowledge about the characteristics and severity of hallucinations is limited, especially in modalities other than auditory. Aim This review summarises the causes, phenomenology, severity, and treatment options of hallucinations and other psychotic symptoms in BPD. Methods The PubMed database was used with the following key terms: “borderline personality disorder” and ‘hallucinations’ and “psychotic symptoms”. Articles were selected between January 1990 and May 2021. The primary keyword search yielded a total of 545 papers, of which 102 articles met the inclusion criteria and were fully screened. Papers from the primary source reference lists were also screened, assessed for eligibility, and then added to the primary documents where appropriate (n = 143). After the relevance assessment, 102 papers were included in the review. We included adult and adolescent studies to gather more recent reviews on this topic. Results Hallucinations are significantly prevalent in BPD, mainly auditory, similar to schizophrenia spectrum disorders. The relationship between hallucinations and depression, anxiety, suicidality, schizotypy, and loneliness in BPD has been discovered but requires more research. Studies for treatment options for hallucinations in BPD are lacking. Conclusion Recognition of psychotic symptoms in patients with BPD as distinguished psychopathological phenomena instead of diminishing and overlooking them is essential in the clinical assessment and can be useful in predicting complications during treatment. More focused research in this area is needed.

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Section: Discussion and Future Directionsmentioning

confidence: 99%

Hallucinations and Other Psychotic Symptoms in Patients with Borderline Personality Disorder

Minaříková¹,

Praško²,

Holubová³

et al. 2022

NDT

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“…In a pilot study of 16 young patients with FEP and BPP, Gleeson et al (2012) demonstrated the efficacy and feasibility of a brief and hybrid psychosocial program combining elements of early intervention for BPD within a specialized FEP intervention. In addition, a placebo controlled randomized trial of the effectiveness of aripiprazole for auditory verbal hallucinations in young people with concurrent BPD and FEP is underway (Chanen et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Co‐occurring first‐episode psychosis and borderline personality pathology in an early intervention for psychosis cohort

Schandrin

Francey

Nguyen

et al. 2022

Early Intervention Psych

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Introduction Borderline personality disorder (BPD) is common among people diagnosed with first episode of psychosis (FEP), but is often under‐recognized and under‐researched. This study aimed to determine: (i) the prevalence of borderline personality pathology (subthreshold features and categorical disorder) in a FEP cohort (termed FEP + BPP); (ii) demographic and clinical factors associated with FEP + BPP; (iii) the symptomatic and functional outcomes. Methods This study was conducted within the Early Psychosis Prevention and Intervention Centre (EPPIC) at Orygen over the 30‐month period between 2014 and 2016. BPP was evaluated by using the Structured Clinical Interview for DSM‐IV Axis II Personality Questionnaire BPD criteria. Results In a cohort of 457 young people with a FEP (mean age 19.5 years, 56% male), 18.4% had borderline personality pathology (BPP). Compared with FEP alone, young people with FEP + BPP were more likely to be female, younger, Australian‐born. In addition, young people with FEP + BPP were more likely to be diagnosed with Psychosis NOS, present with more severe hallucinations, and have alcohol abuse. Young people with FEP + BPP had more relationship difficulties at presentation and they were more likely to suffer of depression and to engage in self‐harm throughout the follow‐up. In relation to outcome, FEP + BPP was not associated with different rates of remission or relapse, however they were less likely to be admitted to hospital at presentation or involuntarily during their episode of care. Conclusion BPP is a common occurrence in psychotic disorders and is associated with more severe hallucinations and depression with higher risks of self‐harm. Specific interventions need to be developed.

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“…However, no randomized-controlled trial (RCT) has tested whether conventional pharmacotherapy for AVH in SZ is applicable to AVH in BPD (68). To address this important question, our group is conducting the first RCT on aripiprazole in youth with BPD and AVH (69). With regard to psychological interventions, the results of the current study indicate that changing appraisals of supremacy of voices, along with negative voice content, could lead to a reduction in depression among youth voice-hearers, including those with BPD.…”

Section: Discussionmentioning

confidence: 99%

Preliminary Evidence for the Cognitive Model of Auditory Verbal Hallucinations in Youth With Borderline Personality Disorder

et al. 2019

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Objectives: This is the first study to explore cognitive, emotional, and behavioral responses to voices in youth with borderline personality disorder (BPD) compared with those with schizophrenia spectrum disorder (SZ), and to examine if negative appraisals of voices predict depression and anxiety across the groups. Methods: The sample comprised 43 outpatients, aged 15–25 years, who reported auditory verbal hallucinations (AVH) and were diagnosed with either Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) BPD or SZ. Data were collected using the Psychotic Symptom Rating Scales, the revised Beliefs About Voices Questionnaire, the Voice Rank Scale, and the Depression Anxiety Stress Scale. Results: Youth with BPD did not differ from youth with SZ in beliefs about the benevolence or malevolence of voices. Youth with BPD appraised their voices as more omnipotent and of higher social rank in relation to themselves, compared with youth with SZ. In both diagnostic groups, beliefs about malevolence and omnipotence of voices were correlated with more resistance toward voices, and beliefs about benevolence with more engagement with voices. In addition, perceiving the voices as being of higher social rank than oneself and negative voice content were both independent predictors of depression, irrespective of diagnostic group. In contrast, negative appraisals of voices did not predict anxiety after adjusting for negative voice content. Conclusions: This study replicated the link between negative appraisals of voices and depression that has been found in adults with SZ in a mixed diagnostic youth sample. It, thus, provides preliminary evidence that the cognitive model of AVH can be applied to understanding and treating voices in youth with BPD.

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Aripiprazole compared with placebo for auditory verbal hallucinations in youth with borderline personality disorder: Protocol for the VERBATIM randomized controlled trial

Cited by 9 publications

References 71 publications

Hallucinations and Other Psychotic Symptoms in Patients with Borderline Personality Disorder

Hallucinations and Other Psychotic Symptoms in Patients with Borderline Personality Disorder

Co‐occurring first‐episode psychosis and borderline personality pathology in an early intervention for psychosis cohort

Preliminary Evidence for the Cognitive Model of Auditory Verbal Hallucinations in Youth With Borderline Personality Disorder

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