BPD is characterized by a chaotic emotional climate with impulsivity and instability of self-image, affect, and relationships. Most BPD symptoms, including psychosis, often are exacerbated by the perception of abandonment or rejection and other inter- personal stressors.
In patients with BPD psychotic symptoms typically occur in reaction to stressful events (e.g. [20,23,50]). Their occurrence might therefore be moderated by further consequences of childhood trauma, namely high sensitivity to stress, and symptoms of PTSD.
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.
One of BPD criteria is transient stress-related paranoid thoughts. In addition, the clinical picture includes cognitive-perceptual symptoms such as suspiciousness, ideations of reference, paranoid thoughts, delusions, derealization, depersonalization, and hallucination-like symptoms.
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.
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.
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.
Psychotherapy is considered a first-line treatment for BPD and is often used to treat schizophrenia in combination with medication. Specific types of therapy used for BPD include: dialectical behavioral therapy (DBT) cognitive behavioral therapy (CBT)
First episode psychosis (FEP) is defined as the first time a person outwardly shows symptoms of psychosis. When patients with FEP become aware of their problems, they show distress and confusion, ruminate their symptoms, and have interpersonal problems caused by enhanced sensitivity (1).
listen to the way that the person explains and understands their experiences. not state any judgements about the content of the person's beliefs and experiences. not argue, confront or challenge someone about their beliefs or experiences. accept if they don't want to talk to you, but be available if they change their ...
Splitting is a psychological mechanism which allows the person to tolerate difficult and overwhelming emotions by seeing someone as either good or bad, idealised or devalued. This makes it easier to manage the emotions that they are feeling, which on the surface seem to be contradictory.
These feelings of suspiciousness and paranoia may last for just a few days, a few weeks, or indefinitely. Stress-related paranoid ideation is the term chosen by mental health professionals to describe this state of mind, which can cause great misery and consternation among people with borderline personality disorder.
Borderline personality disorder is a mental illness that severely impacts a person's ability to regulate their emotions. This loss of emotional control can increase impulsivity, affect how a person feels about themselves, and negatively impact their relationships with others.
Environmental factors
being a victim of emotional, physical or sexual abuse. being exposed to long-term fear or distress as a child. being neglected by 1 or both parents. growing up with another family member who had a serious mental health condition, such as bipolar disorder or a drink or drug misuse problem.
Antipsychotics are widely used in BPD, as they are believed to be effective in improving impulsivity, aggression, anxiety and psychotic symptoms [Nose et al. 2006; American Psychiatric Association, 2001]. Evidence supports their use in the treatment of cognitive-perceptual symptoms [Herpertz et al.
Symptoms of psychosis
hallucinations – where a person hears, sees and, in some cases, feels, smells or tastes things that do not exist outside their mind but can feel very real to the person affected by them; a common hallucination is hearing voices.
Psychosis is when people lose some contact with reality. This might involve seeing or hearing things that other people cannot see or hear (hallucinations) and believing things that are not actually true (delusions).
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.
Paranoid thoughts for someone with BPD typically are categorized as intense beliefs about the malicious intentions of others. Sometimes paranoia can manifest as being afraid that two strangers on the street talking and laughing are actually talking and laughing about you.
Research has shown that the prognosis for BPD is actually not as bad at once thought. Almost half of people who are diagnosed with BPD will not meet the criteria for a diagnosis just two years later. Ten years later, 88% of people who were once diagnosed with BPD no longer meet the criteria for a diagnosis.
Objective: Borderline personality disorder is a disabling and dramatic psychiatric condition. To date, its pathophysiology remains unclear. Scientific evidence seems to have found underlying, nonfocal, central nervous system dysfunction in borderline personality disorder.
Between 50% and 90% of patients with BPD report hearing voices that other people do not hear (Yee et al., 2005; Kingdon et al., 2010). Importantly, such auditory verbal hallucinations (AVH) are a risk factor for suicide plans, attempts, and hospitalization (Miller et al., 1993; Zonnenberg et al., 2016).