The use of antipsychotics in patients with a borderline personality disorder and verbal auditory hallucinations

Background: Verbal auditory hallucinations (VAH) are experienced by 46% of the patients with a borderline personality disorder (BPD). They may constitute a persistent source of distress. In patients with a schizophrenia spectrum disorder, the first choice of treatment for such hallucinations is antipsychotics. Since the effectiveness of these compounds in BPD is largely unknown, the current study focuses on the effectiveness of antipsychotics on VAH in patients with BPD. Method: Patients with BPD who experienced VAH were interviewed with the aid of the Psychotic Symptom Rating Scales – Auditory Hallucinations Rating Scale (PSYRATS - AHRS). To assess improvement over time a pre- and post-test was carried out. A logistic regression analysis was used to investigate the likelihood that receiving antipsychotics was predicted by the degree of suffering from VAH in patients with BPD at pre-test. A Wilcoxon signed rank test was used to investigate improvement over time in degree of...Show moreBackground: Verbal auditory hallucinations (VAH) are experienced by 46% of the patients with a borderline personality disorder (BPD). They may constitute a persistent source of distress. In patients with a schizophrenia spectrum disorder, the first choice of treatment for such hallucinations is antipsychotics. Since the effectiveness of these compounds in BPD is largely unknown, the current study focuses on the effectiveness of antipsychotics on VAH in patients with BPD. Method: Patients with BPD who experienced VAH were interviewed with the aid of the Psychotic Symptom Rating Scales – Auditory Hallucinations Rating Scale (PSYRATS - AHRS). To assess improvement over time a pre- and post-test was carried out. A logistic regression analysis was used to investigate the likelihood that receiving antipsychotics was predicted by the degree of suffering from VAH in patients with BPD at pre-test. A Wilcoxon signed rank test was used to investigate improvement over time in degree of suffering and general functioning. A Man-Whitney U test was used to investigate the expectation that patients with BPD and VAH who use antipsychotics experience a larger decrease in the degree of suffering from VAH than patients with BPD and VAH who do not use antipsychotics. Results: Among the 23 patients thus assessed, no improvement over time was found in the degree of suffering or in general functioning when using antipsychotics. Conclusion: Antipsychotics may not be effective in treating VAH in patients with BPD. Future research among a larger patient group may need to take into account the types of antipsychotic prescribed, dosages, and duration of treatment.Show less

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The use of antipsychotics in patients with a borderline personality disorder and verbal auditory hallucinations