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EV1050

Sınırda kişilik bozukluğunda psikotik belirtilerin fenomenolojisi: anlatısal derleme (The phenomenology of psychotic symptoms in borderline personality disorder: a narrative review)

THE PHENOMENOLOGY OF PSYCHOTIC SYMPTOMS IN BORDERLINE PERSONALITY DISORDER: A NARRATIVE REVIEW

Psychotic symptoms in borderline personality disorder are common and clinically significant, are phenomenologically similar to those of the schizophrenia spectrum, and are most clearly distinguished by the absence of negative symptoms and thought disorder.

The aim of this study is to review the phenomenology and clinical significance of psychotic symptoms in borderline personality disorder (BPD). A narrative review was conducted based on recent reviews, studies comparing BPD with schizophrenia, and longitudinal cohorts. According to the prevalence data reported in the poster, 20% to 60% of patients with BPD report any psychotic symptom, 29% to 50% report auditory hallucinations, and 17% to 29% report delusions; persistent symptoms lasting longer than six months are associated with a poorer course. Hallucinations are multisensory (auditory, visual, tactile, and olfactory), predominantly auditory verbal, derogatory and malevolent in content, prolonged, daily, distressing, and difficult to control; they are often linked to past trauma. Paranoid content and delusions of guilt predominate among delusions, which may be held with strong conviction and persist over time. Compared with schizophrenia, auditory hallucinations are similar in frequency, duration, associated distress, and beliefs about voices; in BPD, hallucinations are less integrated into delusional systems, while negative symptoms and thought disorder are rare. Associated factors include interpersonal stress (particularly abandonment), childhood emotional abuse, dissociation, loneliness, and schizotypy; comorbid posttraumatic stress disorder (PTSD) is identified as the strongest predictor. In conclusion, dismissive terms that characterize these symptoms as transient or pseudopsychotic should be abandoned, and symptoms should be assessed and treated individually; although the overlap poses a risk of misdiagnosis, certain features aid differential diagnosis.

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