Merrett Zalie, Rossell Susan L, Castle David J
Brain and Psychological Sciences Research Centre (BPsyC), Swinburne University of Technology, Hawthorn, VIC, Australia
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.
Aust N Z J Psychiatry. 2016 Jul;50(7):640-8. doi: 10.1177/0004867416632595. Epub 2016 Feb 24.
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.
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.
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.
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.
在临床环境中，有大量临床和实证证据表明，约50%的边缘型人格障碍患者会经历幻听。然而，对这些幻听现象学的研究有限。本研究的目的是回顾和比较我们目前对边缘型人格障碍中幻听的理解与精神病性障碍患者的幻听，批判性地分析现有关于边缘型人格障碍中幻听的研究，并找出当前知识中的差距，这将有助于指导未来的研究。
使用电子数据库Scopus、PubMed和MEDLINE进行文献检索。如果相关研究为英文撰写，是专门针对幻听和边缘型人格障碍的实证研究，经过同行评审，仅使用成年人类且样本以边缘型人格障碍作为主要诊断，并包括一个以精神分裂症等原发性精神病性障碍为对照的组，则纳入这些研究。
我们的检索策略共发现16篇研究边缘型人格障碍中幻听现象学的文章。一些研究提供的证据表明，边缘型人格障碍中的幻听体验与精神分裂症患者的相似，例如，幻听发生在脑海中，且常常涉及迫害性的声音。其他研究揭示了精神分裂症和边缘型人格障碍幻听体验之间的一些差异，边缘型人格障碍的幻听在性质上听起来更具贬损性和自我批评性，且幻听者对幻听的反应在情感上更具抵触性。此外，在一项研究中，精神分裂症组的幻听对日常功能的干扰更大。然而，这些研究数量有限，并未提供这些差异的确切证据。
对边缘型人格障碍中幻听体验的研究有限，这对诊断和治疗构成了重大挑战。更深入地了解确切的现象学特征将有助于我们进行诊断区分并为治疗提供依据。
