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Persistent Hallucinosis in Borderline Personality Disorder - BPD

Dr Anthony Korner

In a series of 171 patients with Borderline Personality Disorder (BPD), the Westmead research program found that about 30% reported a form of auditory hallucinosis. A smaller series of 10 patients were examined in detail through a semi-structured interview and using the Dissociative Experiences Scale (DES), The Structured Clinical Interview for DSM-IV (SCID-D) and McGuffin's Opcrit questionnaire. In this series the hallucinations were persistent, longstanding, and a significant source of distress and disability.

 

The failure to emphasize this phenomenon in current systems of classification risks misdiagnosis or inappropriate treatment. The use of terms such as pseudohallucination tends to be dismissive of the phenomenon, or conveys the sense of it as "not real".  This series is discussed in the context of an emerging literature on hallucinosis in the general population. A nomenclature is proposed for hallucinsosis that is expressed in positive terms, reflecting the clinical significance of the phenomenon in different contexts. The four categories in this schema are: 1) normative hallucinosis, 2) traumatic-intrusive hallucinosis (as in the Westmead series), 3) psychotic hallucinosis, and 4) organic hallucinosis.

Conflict of Interest: None disclosed
Financial Support/Funding: None disclosed
Recorded: Sydney, Australia, August 2005

Anthony Korner
Anthony Korner
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Dr Anthony Korner

Anthony Korner works in Sydney as a psychiatrist and psychotherapist, primarily in public practice. He is Acting Director of the Master of Medicine (Psychotherapy) Program at the University of Sydney and is active in teaching and research as well as clinical practice. His research interests are in psychodynamic psychotherapy, linguistics and philosophy. He has published approximately thirty papers in journals and books. He was on the National Health and Medical Research Council Committee for the development of a guideline for the treatment of Borderline Personality Disorder 2011-13. He's completed a PhD in Linguistics, on psychotherapy. He is the Australian representative on the World Council for Psychotherapy and was Chairman of the organising committee for the 6th World Congress for Psychotherapy, held in Sydney in 2011.  

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