A phenomenological comparison of auditory hallucinations between borderline personality disorder and schizophrenia: A systematic review.
Shih-Ting Tseng, Anna Georgiades
Clinical Psychology & Psychotherapy 2024 DOI: 10.1002/cpp.2958 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Peer reviewed |
|---|---|
| Population | People with borderline personality disorder and people with schizophrenia, as described in 18 included studies |
| Intervention | Cognitive Behaviour Therapy Coping Strategy Enhancement (CBT-CSE) |
| Topics | Philosophy of mind |
| Keywords | Auditory hallucinations Borderline personality disorder Psychosis Schizophrenia |
| Key findings | Compared with schizophrenia, auditory hallucinations in BPD were more persistent and repetitive, with significantly more voice-related distress, more appraisals of omnipotence, and an earlier age of onset. The BPD group also showed more severe depression and anxiety, more childhood trauma, and more negative self-schema. The authors propose CBT-CSE as a promising intervention for hallucination-related distress in BPD and argue DSM-5 may need to acknowledge the broader occurrence of psychotic symptoms in BPD to reduce misdiagnosis. |
Abstract
Borderline personality disorder (BPD) with auditory hallucinations (AHs) may inadvertently be misdiagnosed with a primary psychotic disorder, such as schizophrenia (SZ). This misidentification can lead to challenges in providing effective psychological treatment. This review therefore aims to identify the phenomenological characteristics of AHs in BPD in comparison to SZ, as well as psychological interventions that explicitly target AHs in BPD. A systematic review was conducted to summarise the existing evidence base regarding the phenomenological similarities and differences of AHs in BPD and SZ, along with the identification of psychological interventions for AHs in BPD. Eighteen studies were eligible for inclusion. Compared to the SZ group, BPD clients were characterised by more persistent and repetitive AHs, significantly more voice-related distress and appraisals of omnipotence, and an earlier age of onset of AHs. The BPD group also reported more severe depression and anxiety, a higher incidence of childhood trauma, and more negative self-schema. Cognitive Behaviour Therapy Coping Strategy Enhancement (CBT-CSE) might be a promising intervention to reduce AH-related distress in BPD, although further studies are required to determine its effectiveness. In order to prevent misdiagnosis of AHs in BPD, the DSM-5 may need to acknowledge the broader and more frequent occurrence of psychosis symptoms in BPD clients. Such clarification may enhance diagnostic practices and facilitate more timely access to treatment. There is also a need to develop and trial psychological interventions that explicitly target AHs in BPD.
Comparable studies
Other systematic reviews and meta-analyses on philosophy of mind, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| The brain in flow: A systematic review on the neural basis of the flow state. Participants in studies measuring or manipulating flow state with brain activity recording | 2022 | Systematic review | n = 471 |
| Synergistic, multi-level understanding of psychedelics: three systematic reviews and meta-analyses of their pharmacology, neuroimaging and phenomenology. | 2024 | Systematic review and meta-analysis | |
| Evidence synthesis indicates contentless experiences in meditation are neither truly contentless nor identical Expert texts from Shamatha, Transcendental, and Stillness Meditation traditions | 2022 | Systematic review | n = 135 |
| Novel psychoactive substances (NPS) use in severe mental illness (SMI) patients: Potential changes in the phenomenology of psychiatric diseases Patients with severe mental illness (SMI), such as psychotic patients | 2017 | Systematic review | |
| Scoping review on shamanistic trances practices. | 2024 | Systematic review |
Citations in the library
Cites 8
- Auditory verbal hallucinations and continuum models of psychosis: A systematic review of the healthy voice-hearer literature Clinical Psychology Review November 1, 2016
- Comparison of the Phenomenology of Hallucination and Delusion Characteristics in People Diagnosed With Borderline Personality Disorder and Schizophrenia. Journal of personality disorders August 1, 2022
- A cross-sectional study of Auditory Verbal Hallucinations experienced by people with a diagnosis of Borderline Personality Disorder. Clinical Psychology & Psychotherapy July 28, 2021
- A Phenomenological Exploration of the Voices Reported by Borderline Personality and Schizophrenia Patients. Psychopathology 2021
- Auditory Verbal Hallucinations in Borderline Personality Disorder and the Efficacy of Antipsychotics: A Systematic Review. Frontiers in Psychiatry 2018
and 3 more in the library