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Psychotic symptoms in adolescents with borderline personality disorder features

  • Katherine N. Thompson
  • Marialuisa Cavelti
  • Andrew M. Chanen
Original Contribution
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Abstract

Psychotic symptoms have been found to be relatively common among adults with borderline personality disorder (BPD), and to be a marker of BPD severity, but are not recognised in daily clinical practice in these patients. This study is the first to examine the prevalence of psychotic symptoms in 15–18-year olds with BPD features. It was hypothesised that adolescents with full-threshold BPD would have significantly more psychotic symptoms than adolescents with sub-threshold BPD features, and that both these groups would have significantly more psychotic symptoms than adolescents with no BPD features. A total of 171 psychiatric outpatients, aged 15–18 years, were assessed using a structured interview for DSM-IV personality disorder and categorised into three groups: no BPD features (n = 48), sub-threshold BPD features (n = 80), and full-threshold BPD (n = 43). The groups were compared on measures of psychopathology and functioning (e.g. Youth Self Report, Symptom Check List-90-R, SOFAS). Adolescents with full-threshold BPD reported more psychotic symptoms than the sub-threshold BPD group (p < .001), and both these groups reported more psychotic symptoms than those with no BPD features (p < .001). Adolescents with full-threshold BPD reported more confusion (p < .01), paranoia (p < .001), visual hallucinations (p < .001) and strange thoughts (p < .01), than the other two groups. Psychotic symptoms predicted group membership, determined by BPD severity, after adjusting for other psychopathology and functional impairment (p < .01). Assessment of unusual perceptual experiences, paranoia or odd thoughts is highly clinically relevant in adolescents with BPD features, as these symptoms are associated with a more severe clinical presentation of BPD.

Keywords

Adolescence Borderline personality disorder Psychosis Hallucinations Paranoia 

Notes

Acknowledgements

Dr. Marialuisa Cavelti is supported by the Swiss National Science Foundation, and the Gottfried and Julia Bangerter-Rhyner-Foundation.

Funding

Funding was received for Dr Marialuisa Cavelti as stated in the acknowledgements.

Compliance with ethical standards

Conflict of interest

All Authors declare that they have no conflict of interest.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Orygen, The National Centre of Excellence in Youth Mental HealthParkvilleAustralia
  2. 2.Centre for Youth Mental HealthUniversity of MelbourneMelbourneAustralia
  3. 3.Orygen Youth HealthMelbourneAustralia
  4. 4.Translational Research Centre, University Hospital of Psychiatry and PsychotherapyUniversity of BernBernSwitzerland

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