Delusions have a prevalence of 26% in patients with borderline personality disorder. Hallucinations and delusions are frequently intermittent or even persistent.
Delusional disorder, previously called paranoid disorder, is a type of serious mental illness called a psychotic disorder. People who have it can't tell what's real from what is imagined. Delusions are the main symptom of delusional disorder. They're unshakable beliefs in something that isn't true or based on reality.
Psychotic symptoms, especially hallucinations, are highly prevalent in patients with BPD. Recent studies suggest that hallucinations in BPD are similar to those in patients with psychotic disorders in terms of phenomenology, but their emotional impact seems to be even stronger in patients with BPD.
Recent findings: Both auditory hallucinations and delusional ideation (especially paranoid delusions) are relatively common in individuals with BPD.
For example, in one study, 24% of BPD patients reported severe psychotic symptoms and about 75% had dissociative experiences and paranoid ideation. Thus, we start with an overview regarding the prevalence of psychotic symptoms in BPD patients.
BPD is a very different diagnosis than schizophrenia, though the two can co-exist. While BPD is characterized by a pattern of instability in interpersonal relationships; schizophrenia is characterized by a range of cognitive, behavioral, and emotional dysfunctions.
Paranoia as a Symptom of BPD
Under the influence of non-delusional paranoia, people with BPD may see signs and symbols of hostile intent everywhere. They may detect hidden meanings in speech, body language, casual glances, and other behaviors that would seem non-threatening or perfectly benign to anyone else.
When stressed, people with borderline personality disorder may develop psychotic-like symptoms. They experience a distortion of their perceptions or beliefs rather than a distinct break with reality. Especially in close relationships, they tend to misinterpret or amplify what other people feel about them.
Adult patients with BPD experience a wide range of other psychotic symptoms in addition to AVH, including hallucinations (11% visual hallucinations, 8% gustatory hallucinations, 17% olfactory hallucinations, 15% tactile hallucinations [19]), thought insertion (100%), thought blocking (90%), being influenced by another ...
While 2014 research indicates that people with borderline personality disorder often experience co-occurring psychiatric conditions, the exact rate of schizophrenia and BPD comorbidity specifically isn't clear just yet. A 2010 study found that 17.6% of people diagnosed with schizophrenia also met the criteria for BPD.
Borderline schizophrenia is held to be a valid entity that should be included in the DSM-III. It is a chronic illness that may be associated with many other symptoms but is best characterized by perceptual-cognitive abnormalities. It has a familial distribution and a genetic relationship with schizophrenia.
Petulant BPD: This subtype fluctuates between outbursts of explosive anger and feelings of being unworthy or unloved. They have a strong need to manipulate or control others, and they become very possessive, which results in extreme dissatisfaction in their relationships.
The patients in the current study experienced psychotic symptoms lasting between three weeks and four months. They were characterized by hysterical features, visual disturbances, and a possible history of sexual trauma. The diagnostic and therapeutic implications of these prolonged psychotic episodes is discussed.
Experiencing a delusion or delusions. Poor insight into irrationality of one's delusional belief(s) Believing that others are attempting to harm the person (persecutory type) Belief that others are in love with the person (erotomanic type)
The key feature of a delusion is the degree to which the person is convinced that the belief is true. A person with a delusion will hold firmly to the belief regardless of evidence to the contrary.
Persecutory type: This is one of the most common types of delusions and patients can be anxious, irritable, aggressive, or even assaultive - some patients may be litigious.
A person with BPD is highly sensitive to abandonment and being alone, which brings about intense feelings of anger, fear, suicidal thoughts and self-harm, and very impulsive decisions. When something happens in a relationship that makes them feel abandoned, criticized, or rejected, their symptoms are expressed.
BPD has been linked to the amygdala and limbic systems of the brain, the centres that control emotion and, particularly, rage, fear and impulsive automatic reactions.
A person with BPD tends to see things in extremes, and their feelings can change quickly. It's really about emotional dysregulation rather than being psychotic, neurotic or something on the borderline between them.
One of the most common misdiagnoses for BPD is bipolar disorder. Both conditions have episodes of mood instability.
In particular, there is evidence that BPD is commonly misdiagnosed as Bipolar Disorder, Type 2. One study showed that 40% of people who met criteria for BPD but not for bipolar disorder were nevertheless misdiagnosed with Bipolar Type 2.
The Drama Triangle is commonly exhibited by sufferers of Borderline Personality Disorder (BPD). BPD is typically characterized by the intense emotional turmoil experienced by the individual and those around them.
A pattern of intense and unstable relationships with family, friends, and loved ones. A distorted and unstable self-image or sense of self. Impulsive and often dangerous behaviors, such as spending sprees, unsafe sex, substance abuse, reckless driving, and binge eating.
Over the past three decades, studies have shown that the prevalence of psychotic symptoms ranges from 26% to 54%. Auditory verbal hallucinations are the most common form of psychotic symptoms in patients with BPD.
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. Of the hallucinating patients, 78% experienced AVH at least once per day, for a duration of several days to many years.