30 April 2019

Hearing voices could suggest a more severe form of borderline personality disorder, study finds

Clinicians treating young people living with borderline personality disorder (BPD) should be asking them if they hear voices, as this may indicate a more severe form of BPD, a new study has found.

The Voices study, by researchers at Orygen, the National Centre of Excellence in Youth Mental Health, is the first to comprehensively examine the characteristics of hearing voices (such as the frequency, duration, loudness, and beliefs about the voices’ origins) and other psychotic symptoms in young people living with BPD.

The researchers assessed interview and questionnaire data from 68 young people living with either BPD or schizophrenia who were attending Orygen Youth Health, to evaluate whether there were any differences in the voices and other psychotic symptoms experienced by young people living with BPD and schizophrenia.

Dr Marialuisa Cavelti, who led the research team at Orygen, said the team found no significant difference in the voices heard by young people experiencing BPD and schizophrenia. However, young people with BPD who heard voices showed significantly higher levels of self-harm, paranoia, dissociation, anxiety and stress than those with BPD who did not hear voices, indicating a more severe form of BPD, she said.

Their findings were published in November in the journal Early Intervention in Psychiatry.

Dr Cavelti said the study results showed there was a need for clinicians to ask young people who experience BPD whether they hear voices. Determining whether a young person with BPD heard voices could enhance the accuracy of their treatment and improve their overall outcomes and recovery, she said.

“Clinicians working with people with BPD often dismiss psychotic symptoms such as hearing voices in their clients as these symptoms are not clearly listed in the criteria used to diagnose BPD,” Dr Cavelti said.

“Our study clearly shows that young people who report psychotic symptoms such as hearing voices should be treated with the same seriousness as a young person with schizophrenia who hears voices.”

The Voices study was supported by the Swiss National Science Foundation and the Bangerter-Rhyner-Foundation.