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Suicidality and hospitalisation in patients with borderline personality disorder who experience auditory verbal hallucinations

Published online by Cambridge University Press:  03 February 2017

C.W. Slotema ,
M.B.A. Niemantsverdriet ,
J.D. Blom ,
M. van der Gaag ,
H.W. Hoek  and
I.E.C. Sommer
C.W. Slotema*
Affiliation:
Parnassia Psychiatric Institute, The Hague, The Netherlands
M.B.A. Niemantsverdriet
Affiliation:
Parnassia Psychiatric Institute, The Hague, The Netherlands
J.D. Blom
Affiliation:
Parnassia Psychiatric Institute, The Hague, The Netherlands University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands Leiden University, Faculty of Social Sciences, Leiden, The Netherlands
M. van der Gaag
Affiliation:
Parnassia Psychiatric Institute, The Hague, The Netherlands VU University, Department of Clinical Psychology, Amsterdam, The Netherlands
H.W. Hoek
Affiliation:
Parnassia Psychiatric Institute, The Hague, The Netherlands University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands Columbia University, New York, NYUSA
I.E.C. Sommer
Affiliation:
University Medical Center Utrecht, Department of Psychiatry, Utrecht, The Netherlands
*
⁎Corresponding author. Parnassia Psychiatric Institute, Lijnbaan 4, 2512 VA The Hague, The Netherlands. Tel.: +31 883 573 107; fax: +31 883 584 220. E-mail address: c.slotema@psyq.nl (C.W. Slotema).
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Abstract

Background

In patients with borderline personality disorder (BPD), about 22–50% experience auditory verbal hallucinations (AVH). However, the impact of these hallucinations on suicidal ideation, suicide attempts, crisis-service interventions, and hospital admissions is unknown.

Methods

In a cross-sectional design, data were collected with the Psychotic Symptom Rating Scales (PSYRATS) and the MINI International Neuropsychiatric Interview Plus, as well as from the medical records of a convenience sample of outpatients fulfilling the DSM-IV criteria for BPD.

Results

Of the 89 included patients, 27 experienced AVH. In the latter group, the presence of AVH was associated with a significantly higher incidence of suicidal plans and attempts in the month prior to study participation, more hospitalisations, and a shorter interval until hospitalisation. All subscales of the PSYRATS correlated positively with suicide plans, while the phenomenological and emotional subscales also correlated positively with suicide attempts. Moreover, higher scores on the emotional subscale were associated with more hospital admissions.

Conclusions

AVH experienced by patients with BPD might constitute a risk factor for suicide plans and attempts, and hospitalisation. This finding emphasises that this population requires adequate clinical attention, as well as effective treatment for AVH.

Keywords

Personality disorderSelf-harmSuicide
Type
Original article
Information
European Psychiatry , Volume 41 , Issue 1 , March 2017 , pp. 47 - 52
Copyright
Copyright © European Psychiatric Association 2017

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