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Suicidality and hospitalisation in patients with borderline personality disorder who experience auditory verbal hallucinations

Published online by Cambridge University Press:  03 February 2017

C.W. Slotema ,
M.B.A. Niemantsverdriet ,
J.D. Blom ,
M. van der Gaag ,
H.W. Hoek  and
I.E.C. Sommer
C.W. Slotema*
Affiliation:
Parnassia Psychiatric Institute, The Hague, The Netherlands
M.B.A. Niemantsverdriet
Affiliation:
Parnassia Psychiatric Institute, The Hague, The Netherlands
J.D. Blom
Affiliation:
Parnassia Psychiatric Institute, The Hague, The Netherlands University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands Leiden University, Faculty of Social Sciences, Leiden, The Netherlands
M. van der Gaag
Affiliation:
Parnassia Psychiatric Institute, The Hague, The Netherlands VU University, Department of Clinical Psychology, Amsterdam, The Netherlands
H.W. Hoek
Affiliation:
Parnassia Psychiatric Institute, The Hague, The Netherlands University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands Columbia University, New York, NYUSA
I.E.C. Sommer
Affiliation:
University Medical Center Utrecht, Department of Psychiatry, Utrecht, The Netherlands
*
⁎Corresponding author. Parnassia Psychiatric Institute, Lijnbaan 4, 2512 VA The Hague, The Netherlands. Tel.: +31 883 573 107; fax: +31 883 584 220. E-mail address: c.slotema@psyq.nl (C.W. Slotema).
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Abstract

Background

In patients with borderline personality disorder (BPD), about 22–50% experience auditory verbal hallucinations (AVH). However, the impact of these hallucinations on suicidal ideation, suicide attempts, crisis-service interventions, and hospital admissions is unknown.

Methods

In a cross-sectional design, data were collected with the Psychotic Symptom Rating Scales (PSYRATS) and the MINI International Neuropsychiatric Interview Plus, as well as from the medical records of a convenience sample of outpatients fulfilling the DSM-IV criteria for BPD.

Results

Of the 89 included patients, 27 experienced AVH. In the latter group, the presence of AVH was associated with a significantly higher incidence of suicidal plans and attempts in the month prior to study participation, more hospitalisations, and a shorter interval until hospitalisation. All subscales of the PSYRATS correlated positively with suicide plans, while the phenomenological and emotional subscales also correlated positively with suicide attempts. Moreover, higher scores on the emotional subscale were associated with more hospital admissions.

Conclusions

AVH experienced by patients with BPD might constitute a risk factor for suicide plans and attempts, and hospitalisation. This finding emphasises that this population requires adequate clinical attention, as well as effective treatment for AVH.

Keywords

Personality disorderSelf-harmSuicide
Type
Original article
Information
European Psychiatry , Volume 41 , Issue 1 , March 2017 , pp. 47 - 52
Copyright
Copyright © European Psychiatric Association 2017

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References

Skodol, A.E.Gunderson, J.G.McGlashan, T.H.Dyck, I.R.Stout, R.L.Bender, D.S.et al.Functional impairment in patients with schizotypal, borderline, avoidant, or obsessive-compulsive personality disorder. Am J Psychiatry 2002;159:276–283.CrossRefGoogle ScholarPubMed
Mattia, J.I.Zimmerman, M.Epidemiology. In: Livesly, W.J., editor. Handbook of personality disorders, theory, research, and treatment 2001. Guilford; New York: 107–123.Google Scholar
Grant, B.F.Chou, S.P.Goldstein, R.B.Huang, B.Stinson, F.S.Saha, T.D.et al.Prevalence, correlates, disability, and comorbidity of DSM-IV borderline personality disorder: results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry 2008;69:533–545.CrossRefGoogle ScholarPubMed
Kingdon, D.G.Ashcroft, K.Bhandari, B.Gleeson, S.Warikoo, N.Symons, M.et al.Schizophrenia and borderline personality disorder: similarities and differences in the experience of auditory hallucinations, paranoia and childhood trauma. J Nerv Ment Dis 2010;198:399–403.CrossRefGoogle ScholarPubMed
Slotema, C.W.Daalman, K.Blom, J.D.Diederen, K.M.J.Hoek, H.W.Sommer, I.E.C.Auditory verbal hallucinations in patients with borderline personality disorder are similar to those with schizophrenia. Psychol Med 2012;42:1873–1878.CrossRefGoogle ScholarPubMed
Chopra, H.D.Beatson, J.A.Psychotic symptoms in borderline personality disorder. Am J Psychiatry 1986;143:1605–1607.Google ScholarPubMed
George, A.Soloff, P.H.Schizotypal symptoms in patients with borderline personality disorders. Am J Psychiatry 1986;143:212–215.Google ScholarPubMed
Yee, L.Korner, A.J.McSwiggan, S.Meares, R.A.Stevenson, J.Persistent hallucinosis in borderline personality disorders. Compr Psychiatry 2005;46:147–154.CrossRefGoogle Scholar
Pearse, L.J.Dibben, C.Ziauddeen, H.Denman, C.McKenna, P.J.A study of psychotic symptoms in borderline personality disorder. J Nerv Ment Dis 2014;202:368–371.CrossRefGoogle ScholarPubMed
Pompili, M.Amador, X.F.Girardi, P.Harkavy-Friedman, J.Harrow, M.Kaplan, K.et al.Suicide risk in schizophrenia: learning from the past to change the future. Ann Gen Psychiatry 2007;6:10.CrossRefGoogle ScholarPubMed
Inskip, H.M.Harris, E.C.Barraclough, B.Lifetime risk of suicide for affective disorder, alcoholism and schizophrenia. Br J Psychiatry 1998;172:35–37.CrossRefGoogle Scholar
Palmer, B.A.Pankratz, V.S.Bostwick, J.M.The lifetime risk of suicide in schizophrenia: a re-examination. Arch Gen Psychiatry 2005;62:247–253.CrossRefGoogle Scholar
Hawton, K.Sutton, L.Haw, C.Sinclair, J.Deeks, J.J.Schizophrenia and suicide: systematic review of risk factors. Br J Psychiatry 2005;187:9–20.CrossRefGoogle ScholarPubMed
Hor, K.Taylor, M.Suicide and schizophrenia: a systematic review of rates and risk factors. J Psychopharmacol 2010;24(Suppl. 4):81–90.CrossRefGoogle ScholarPubMed
Kjelby, E.Sinkeviciute, I.Gjestad, R.Kroken, R.A.Løberg, E.M.Jørgensen, H.A.et al.Suicidality in schizophrenia spectrum disorders: the relationship to hallucinations and persecutory delusions. Eur Psychiatry 2015;30:830–836.CrossRefGoogle ScholarPubMed
Fuijta, J.Takahashi, Y.Nishida, A.Okumura, Y.Ando, S.Kawano, M.et al.Auditory verbal hallucinations increase the risk for suicide attempts in adolescents with suicidal ideation. Schizophr Res 2015;168:209–212.CrossRefGoogle Scholar
Black, D.W.Blum, N.Pfohl, B.Hale, N.Suicidal behavior in borderline personality disorder: prevalence, risk factors, prediction, and prevention. J Pers Disord 2004;18:226–239.CrossRefGoogle ScholarPubMed
Paris, J.Zweig-Frank, H.A 27-year follow-up of patients with borderline personality disorder: a review and hypothesis. Compr Psychiatry 2001;42:482–487.CrossRefGoogle Scholar
Zanarini, M.C.Frankenburg, F.R.Hennen, J.Reich, D.B.Silk, K.R.The McLean Study of Adult Development (MSAD): overview and implications of the first six years of prospective follow-up. J Pers Disorders 2005;19:505–523.CrossRefGoogle ScholarPubMed
Pompili, M.Girardi, P.Ruberto, A.Tatarelli, R.Suicide in borderline personality disorder: a meta-analysis. Nord J Psychiatry 2005;59:319–324.CrossRefGoogle ScholarPubMed
Soeteman, D.I.Hakkaart-van Roijen, L.Verheul, R.Busschbach, J.J.V.The economic burden of personality disorders in mental health care. J Clin Psychiatry 2008;69:259–265.CrossRefGoogle ScholarPubMed
First, M.V.Gibbon, M.Spitzer, R.L.Williams, J.B.W.Benjamin, L.S.User's guide for the Structured Clinical Interview for DSM-IV Axis II personality disorders. Washington, DC: American Psychiatric Press; 1997.Google Scholar
Haddock, G.McCarron, J.Tarrier, N.Faragher, E.B.Scales to measure dimensions of hallucinations and delusions: the psychotic symptom rating scales (PSYRATS). Psychol Med 1999;29:879–889.CrossRefGoogle Scholar
Sheehan, D.V.Lecrubier, Y.Sheehan, K.H.Anorim, P.Janavs, J.Weiller, E.et al.The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 1998;59(Suppl. 20):22–33.Google ScholarPubMed
Benjamini, Y.Hochberg, Y.Controlling the false discovery rate: a practical and powerful approach to multiple testing. J Roy Stat Soc 1995;57:289–300.Google Scholar
Sommer, I.E.C.Slotema, C.W.Daskalakis, Z.J.Derks, E.M.Blom, J.D.van der Gaag, M.The treatment of hallucinations in schizophrenia. Schizophr Bull 2012;38:704–714.CrossRefGoogle Scholar
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