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