A comparison of thought and perception disorders in borderline personality disorder and schizophrenia: psychotic experiences as a reaction to impaired social functioning

BMC Psychiatry

Rocco Luigi Picci¹  Pier Maria Furlan¹  Elvezio Pirfo²  Marinella Dalmotto²  Francesco Oliva¹ 

[1] Department of Clinical and Biological Sciences, “San Luigi Gonzaga” Medical School, University of Turin, Regione Gonzole 10, Turin, 10043, Orbassano TO, Italy;Department of Mental Heath “G. Maccacaro”, Azienda Sanitaria Locale TO2, Turin, Italy

关键词: DSM;    Non-delusional paranoia;    Social functioning;    Quasi-psychotic symptoms;    Psychotic-like symptoms;    Perception disorder;    Thought disorder;    Schizophrenia;    Borderline personality disorder;   

Others  :  1118412
DOI  :  10.1186/s12888-014-0239-2

 received in 2014-05-23, accepted in 2014-08-15,  发布年份 2014

【 摘 要 】

Background

Although previous studies suggest a high frequency of psychotic symptoms in DSM-IV Borderline Personality Disorder (BPD) there is currently no consensus on their prevalence and characteristics (type, frequency, duration, location etc.). Similarly, there are few papers addressing psychotic reactivity, the crucial aspect of BPD included in the ninth criterion for DSM-IV BPD, which remained unchanged in DSM-IV-TR and DSM-5. The purposes of the present study were to compare thought and perception disorders in patients with DSM-IV BPD and schizophrenia (SC), investigating their relationship with social functioning.

Methods

Thought and perception disorders and social functioning over the previous two years were assessed by the Diagnostic Interview for Borderline Revised (DIB-R) and Personal and Social Performance scale (PSP) respectively in outpatients with DSM-IV BPD (n = 28) or DSM-IV SC (n = 28).

Results

Quasi-psychotic thought (i.e. transient, circumscribed and atypical psychotic experiences) was more frequent in BPD (BPD = 82.1%, SC = 50%, p = 0.024); whereas true psychotic thought (i.e. Schneiderian first-rank, prolonged, widespread and bizarre psychotic symptoms) was more frequent in SC (SC = 100%, BPD = 46.4%, p < 0.001). However both types of psychotic features were prevalent in both groups. Non-delusional paranoia (e.g. undue suspiciousness and ideas of references) was ubiquitous but was more severe in BPD than SC patients (U(54) = 203.5, p = 0.001). In the BPD group there was a strong negative correlation between personal and social functioning and non-delusional paranoia (τ(28) = 0.544, p = 0.002) and level of personal and social functioning was a significant predictor of the severity of non-delusional paranoia only in the BPD group (β = −0.16, t(23) = 2.90, p = 0.008).

Conclusions

BPD patients reported less severe psychotic experiences with more frequent quasi-psychotic thought, less frequent true psychotic thought and more severe non-delusional paranoia than SC patients. Interpersonal functioning seems to predict non-delusional paranoia in BPD, which would validate the “stress-related paranoid ideation”, included in the ninth diagnostic criterion for DSM-IV and DSM-5 BPD. PBD patients had higher scores on the psychotic experiences subscale that support the use of a dimensional assessment of the severity of thought and perception disorders, for example the Clinician-Rated Dimensions of Psychosis Symptom Severity introduced in DSM-5, Section III.

【 授权许可】

   
2014 Oliva et al.; licensee BioMed Central Ltd.

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