Similarities and Differences in Borderline Personality Disorder and Schizophrenia With Voice Hearing

Abstract

The aim of the study was to identify psychopathological similarities and differences in borderline personality disorder (BPD) and schizophrenia. We compared 23 female patients with a BPD and 21 female patients with schizophrenia according to auditory verbal hallucinations (AVHs), dissociation, childhood trauma, and additional psychotic symptoms. The character of AVH was similar with regard to commenting voices, location, and foreign voices. Major differences were found in the prevalence of negative symptoms, bizarre delusions, and formal thought disorder. These characteristics were more frequent in schizophrenia and negatively correlated with childhood traumatization. A history of childhood traumatization and dissociative symptoms was significantly more frequent in BPD. AVHs in BPD and schizophrenia are not distinguishable in terms of the historically grown criteria in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision for diagnosing schizophrenia. Other symptoms such as delusions, negative symptoms, formal thought disorder, and dissociative psychopathology could help to differentiate between both groups.

Exploratory comparison of auditory verbal hallucinations and other psychotic symptoms among youth with borderline personality disorder or schizophrenia spectrum disorder

“…For example, auditory verbal hallucinations (AVH) are reported to occur in 13.7%‐50% of adults with BPD (Kelleher & DeVylder, ; Merrett, Rossell, & Castle, ; Niemantsverdriet et al, ). They are reported to be similar to AVH in schizophrenia with regard to most phenomenological characteristics (Merrett et al, ), such as frequency, duration, location, loudness and beliefs about the origin of voices (Kingdon et al, ; Pearse, Dibben, Ziauddeen, Denman, & McKenna, ; Slotema et al, ; Tschoeke et al, ). Some differences have also been found.…”

“…Recent research in adults with BPD has challenged these assumptions, reporting that multimodal hallucinations, delusions, paranoia and dissociation are common among people with BPD (Kingdon et al, ; Niemantsverdriet et al, ; Slotema et al, ; Tschoeke, Steinert, Flammer, & Uhlmann, ). For example, auditory verbal hallucinations (AVH) are reported to occur in 13.7%‐50% of adults with BPD (Kelleher & DeVylder, ; Merrett, Rossell, & Castle, ; Niemantsverdriet et al, ).…”

“…Hallucinations in adults with BPD have been reported to co‐occur with delusional thinking, but not with negative or disorganized symptoms (Niemantsverdriet et al, ). Compared with adults with schizophrenia and AVH, adults with BPD and AVH have been reported to have less severe delusions, conceptual disorganization and negative symptoms (Tschoeke et al, ). Importantly, the presence and severity of hallucinations in patients with BPD has been correlated with a greater number of co‐occurring psychiatric diagnoses, along with a greater number of suicidal plans and attempts, and more hospitalizations (Slotema et al, ).…”

Varieties of Voice-Hearing: Psychics and the Psychosis Continuum

“…BPD involves social dysfunction and is associated with developmental trauma and neglect, in which voices and dissociative experiences are common, 56 and wherein voices are similar to those experienced by patients with schizophrenia. 57 Other items that did not survive correction may reflect aspects of the illness narrative: treatment-seeking voicehearers were more likely to ascribe voices to themselves, more likely to say they were the result of brain processes, and less likely to call them comforting. In order to more fully illustrate the similarities and differences between the psychic group and their treatment-seeking counterparts, we include representative quotations regarding voicehearing experiences (table 4).…”

Trauma and the psychosis spectrum: A review of symptom specificity and explanatory mechanisms

“…The main effect of TLEs on borderline personality disorder appears particularly prominent, such that the association between sexual abuse and this disorder compared to the association for controls yielded an odds ratio of 6.07, the highest across all disorders assessed although the base rate of this disorder in the traumatized sample was 1.8% (Cutajar et al, 2010b). In a recent study comparing a sample of women with either schizophrenia or borderline personality disorder, TLEs of all types were more prevalent in the latter sample (Tschoeke, Steinert, Flammer, & Uhlmann, 2014). However, both samples in this study were selected based on the experience of auditory visual hallucinations in the past year, making it impossible to ascertain if the links between TLEs and borderline personality disorder persist controlling for psychotic experiences.…”