Persistent hallucinosis in borderline personality disorder.
A case series of 10 patients with a diagnosis of borderline personality disorder (BPD) presenting with auditory hallucinosis is examined. In this series, the hallucinations were persistent, longstanding, and a significant source of distress and disability. Extrapolating from this series to our sample of 171 patients with BPD suggests that a form of auditory hallucinosis may occur in almost 30% of this population. The failure to emphasize this phenomenon in current systems of classification risks misdiagnosis or inappropriate treatment. Use of terms such as pseudohallucination or quasi hallucination dismisses the phenomenon as unimportant or as "not real." There is an emerging literature on the frequency of hallucinosis among nonpatients. A basis for understanding different forms of hallucination is discussed with reference to the concept of "normativity." We propose a nomenclature for hallucinosis that is expressed in positive terms, reflecting the clinical significance of the phenomenon in different contexts: (1) normative hallucinosis, (2) traumatic-intrusive hallucinosis (as in our series), (3) psychotic hallucinosis, and (4) organic hallucinosis.
Yee
Lesley
L
Department of Psychological Medicine, University of Sydney at Westmead Hospital, Wentoworthville, NSW 2145, Australia.
Yee
Leslie
L
Korner
Anthony James
AJ
McSwiggan
Sally
S
Meares
Russell Ainslie
RA
Stevenson
Janine
J
D000328:Adult; D001883:Borderline Personality Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004185:Disability Evaluation; D005260:Female; D006212:Hallucinations / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D011613:Psychotherapy; D011788:Quality of Life / Q000523:psychology; D012016:Reference Values; D012650:Self Disclosure; D012803:Sick Role; D013223:Statistics as Topic; D009626:Terminology as Topic