Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Curr Opin Psychiatry. 2013 Jan;26(1):113-9. doi: 10.1097/YCO.0b013e32835a2ae7.
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.
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.
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.
本文旨在回顾边缘型人格障碍（BPD）中精神病特征的患病率、表现和治疗，讨论可能与这些特征发生相关的因素。
约 20-50%的 BPD 患者报告存在精神病症状。从表现、情绪影响和随时间推移的持续性来看，BPD 患者的幻觉与精神病患者的幻觉相似。尽管需要进一步研究 BPD 患者精神病现象的确切性质，但使用“假性精神病”或“类精神病”等术语具有误导性，应避免使用。童年创伤可能在 BPD 患者精神病症状的发展中发挥重要作用，如同在其他人群中一样。需要进一步研究合并症的作用，尤其是创伤后应激障碍（PTSD）。非典型抗精神病药似乎对一些患者有益；关于精神病症状心理治疗的证据很少。
精神病症状，尤其是幻觉，似乎是 BPD 的一个重要特征。需要对 BPD 中精神病症状的潜在中介因素和适当治疗方法进行更多研究，目前的诊断系统可能需要修订，以强调精神病症状。
