Psychopathology of psychotic experiences in borderline patients: An exploratory study

Objective

Psychotic symptoms are a prevalent and distressing phenomenon in patients diagnosed with borderline personality disorder (BPD) and represent a significant challenge to effective treatment. However, there is a lack of knowledge about the specific characteristics of these phenomena. The aim of this study was to examine the psychotic experiences of patients with borderline personality disorder (BPD) and compare them with those of patients with psychotic disorders, with particular attention to the role of dysphoria, which has been proposed to be at the core of BPD functioning from a psychopathological-dynamic perspective.

Methods

Two groups of adult psychiatric patients (aged 18-65 years), one with BPD and the other with schizophrenia, were administered a questionnaire assessing the presence and phenomenology of psychotic experiences (QPE), together with self-reports measuring other dimensions.

Results

The results showed that patients with BPD had a greater diversity of hallucinations in terms of sensory modalities, a higher prevalence but lower severity of paranoid delusions and, most importantly, an increased degree of situational dysphoria, especially triggered by recent interpersonal events.

Conclusions

This suggests that psychotic symptoms in borderline patients may begin to manifest a distinctive psychopathological profile that warrants further investigation and attention from the scientific community.