title: Comparing the experience of voices in borderline personality disorder with the experience of voices in a psychotic disorder: A systematic review.
abstract: OBJECTIVE
  In clinical settings, there is substantial evidence both clinically and empirically to suggest that approximately 50% of individuals with borderline personality disorder experience auditory verbal hallucinations. However, there is limited research investigating the phenomenology of these voices. The aim of this study was to review and compare our current understanding of auditory verbal hallucinations in borderline personality disorder with auditory verbal hallucinations in patients with a psychotic disorder, to critically analyse existing studies investigating auditory verbal hallucinations in borderline personality disorder and to identify gaps in current knowledge, which will help direct future research.
  
  
  METHODS
  The literature was searched using the electronic database Scopus, PubMed and MEDLINE. Relevant studies were included if they were written in English, were empirical studies specifically addressing auditory verbal hallucinations and borderline personality disorder, were peer reviewed, used only adult humans and sample comprising borderline personality disorder as the primary diagnosis, and included a comparison group with a primary psychotic disorder such as schizophrenia.
  
  
  RESULTS
  Our search strategy revealed a total of 16 articles investigating the phenomenology of auditory verbal hallucinations in borderline personality disorder. Some studies provided evidence to suggest that the voice experiences in borderline personality disorder are similar to those experienced by people with schizophrenia, for example, occur inside the head, and often involved persecutory voices. Other studies revealed some differences between schizophrenia and borderline personality disorder voice experiences, with the borderline personality disorder voices sounding more derogatory and self-critical in nature and the voice-hearers' response to the voices were more emotionally resistive. Furthermore, in one study, the schizophrenia group's voices resulted in more disruption in daily functioning. These studies are, however, limited in number and do not provide definitive evidence of these differences.
  
  
  CONCLUSIONS
  The limited research examining auditory verbal hallucinations experiences in borderline personality disorder poses a significant diagnostic and treatment challenge. A deeper understanding of the precise phenomenological characteristics will help us in terms of diagnostic distinction as well as inform treatments.
authors.affiliation: Brain and Psychological Sciences Research Centre (BPsyC), Swinburne University of Technology, Hawthorn, VIC, Australia zales0@hotmail.com.
authors.forename: Zalie
authors.initials: Z
authors.lastname: Merrett
authors.affiliation: Brain and Psychological Sciences Research Centre (BPsyC), Swinburne University of Technology, Hawthorn, VIC, Australia Monash Alfred Psychiatry Research Centre (MAPrc), The Alfred Hospital and Monash University School of Psychology and Psychiatry, Melbourne, VIC, Australia Department of Psychiatry, St. Vincent's Hospital, Melbourne, VIC, Australia.
authors.forename: Susan L
authors.initials: SL
authors.lastname: Rossell
authors.affiliation: Department of Psychiatry, St. Vincent's Hospital, Melbourne, VIC, Australia Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia.
authors.forename: David J
authors.initials: DJ
authors.lastname: Castle
mesh_terms: D001883:Borderline Personality Disorder / Q000523:psychology*; D006212:Hallucinations / Q000523:psychology*; D006801:Humans; D011618:Psychotic Disorders / Q000523:psychology*; D012565:Schizophrenic Psychology
keywords: Borderline personality disorder; auditory verbal hallucinations; schizophrenia; voices