title: Psychotic symptoms in patients with borderline personality disorder:  prevalence and clinical management.
abstract: OBJECTIVE
  The aim of this article is to review findings on the prevalence, phenomenology and treatment of psychotic features in borderline personality disorder (BPD), and to discuss factors that might be related to their occurrence.
  
  
  RESULTS
  Of patients with BPD about 20-50% report psychotic symptoms. Hallucinations can be similar to those in patients with psychotic disorders in terms of phenomenology, emotional impact, and their persistence over time. Although more research is needed on the exact nature of psychotic phenomena in patients with BPD, terms like pseudo-psychotic or quasi-psychotic are misleading and should be avoided. Childhood trauma might play an important role in the development of psychotic symptoms in patients with BPD, as in other populations. More research is necessary on the role of comorbid disorders, especially posttraumatic stress disorder (PTSD). Atypical antipsychotics seem to be beneficial in some patients; evidence on psychotherapy of psychotic symptoms is sparse.
  
  
  CONCLUSIONS
  Psychotic symptoms, especially hallucinations, seem to be an important feature of BPD. More research on potential mediators and adequate treatment approaches for psychotic symptoms in BPD is needed, and current diagnostic systems might require revision to emphasise psychotic symptoms.
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. katrin.schroeder@uke-hh.de
authors.forename: Katrin
authors.initials: K
authors.lastname: Schroeder
authors.forename: Helen L
authors.initials: HL
authors.lastname: Fisher
authors.forename: Ingo
authors.initials: I
authors.lastname: Schäfer
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use; D001883:Borderline Personality Disorder / Q000523:psychology*; D015897:Comorbidity; D006801:Humans; D011613:Psychotherapy / Q000379:methods; D011618:Psychotic Disorders / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology
chemical_list: D014150:Antipsychotic Agents