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sleepy borderline

Is having Schizophrenia or Schizoaffective with BPD really rare?

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Today I was talking to my new psychiatrist. I told him I was worried because for 10 years my diagnosis was Schizoaffective ( Axis 1) and BPD ( axis 2). I told him I thought maybe my Schizoaffective has gone into remission, because I got off my anti-psychotics in 2006 and didn't have a problem until 2010 when I started having really severe insomnia and stuff like paranoid symptoms I have had more in past came back, some trouble thinking and concentrating, and scattered thoughts. I was put on a low dose of Seroquel, which I think would be too low to do anything for psychosis anyways, but having that as my diagnosis for 10 years I always wonder if it was true.

 

  Anyways, he was telling me that having both Schizophrenia or Schizoaffective disorder and BPD is quite rare. Is that true? How rare is it? I'm just wondering if anyone on here has both. If so, what are your experiences in having both like?

 

I'm hope I'm not being too nosey by asking this, I really don't know if it's a rare as he says it is or not. I tried looking it up online and there is a lot of info about people who have both Bipolar and Borderline but not about Schizoaffective and Borderline.

 

 

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Also interested to know more about this. I've been diagnosed as Schizoaffective (depressive subtype) with borderline traits - I think the latter is because I was missing one criteria but fit the others well enough.

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I know this is a old topic but I have something to add.

I am diagnosed Schizoaffective Disorder, Bipolar type  and with Borderline Personality ''Traits''. I asked my pdoc specifically about the BPD because I feel like I don't have it because I maintain steady relationships and stuff, ect. He said because my IQ isn't quite 100 I have not developed full blown BPD because somehow having a low IQ has protected me from developing it.

 

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I've been diagnosed with both BPD and schizoaffective disorder, although not by the same person. 

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When I was IP, there was girl with BPD and schizoaffective. Individuals with BPD can also experience psychosis.  

I did a quick search on PubMed and came up with these articles about comorbid BPD in SZ/SZA patients or psychosis in BPD patients, I couldn't find many full text articles but I copied what's important from the abstract. I didn't check if these were peer-reviewed articles. 

Examining the course and outcome of individuals diagnosed with schizophrenia and comorbid borderline personality disorder.
Bahorik AL, Eack SM

This research examined the prevalence of comorbid borderline personality disorder (BPD) in a sample of schizophrenia inpatients, and then investigated the degree to which BPD comorbidity impacted symptom and functional outcomes after 1-year post-hospital discharge. A sample of 142 individuals with a diagnosis of schizophrenia (n = 100) or schizoaffective disorder (n = 42) from the MacArthur Violence Risk Assessment Study were administered the Structured Interview for DSM-III-R Personality (SIDP-R). Symptom and functional outcome data were gathered during hospitalization and at 1-year follow-up to analyze differences in symptom and functioning characteristics between those diagnosed with and without BPD. Results indicated that comorbid BPD was present in a non-trivial proportion (17.6%, n = 25) of the sample, based on SIDP-R assessment. Our findings indicate that the co-occurrence of schizophrenia and BPD is not infrequent and that BPD has a significant negative longitudinal impact on the course and outcome of patients with schizophrenia.

Auditory verbal hallucinations in patients with borderline personality disorder are similar to those in schizophrenia.
Slotema CW, Daalman K, Blom JD, Diederen KM, Hoek HW, Sommer IE.

Auditory Verbal Hallucinations (AVH) in BPD patients are phenomenologically similar to those in schizophrenia, and different from those in healthy individuals. As AVH in patients with BPD fulfill the criteria of hallucinations proper, we prefer the term AVH over 'pseudohallucinations', so as to prevent trivialization and to promote adequate diagnosis and treatment.

 

[Auditory verbal hallucinations in patients with borderline personality disorder].
Zonnenberg C, Niemantsverdriet MB, Blom JD, Slotema CW.

27% of patients with a BPD experience AVH. Phenomenologically, these percepts are indistinguishable from those experienced by patients with a schizophrenia spectrum disorder. Hallucinations in several modalities were present in 50% of the patients with BPD. The mean time-span in which AVH were experienced was 17 years, the mean frequency was several minutes per day. The degree of suffering was high and the patient's life was interrupted to a moderate degree.

 

Hallucinations and borderline personality disorder: a review
Gras A, Amad A, Thomas P, Jardri R.

The hallucinatory experiences observed in BPD appeared phenomenologically similar to those described in the schizophrenia spectrum in terms of vividness, duration, spatial localization, beliefs about malevolence or omnipotence. Conversely, the hallucinatory content appeared more negative and potentially more distressful. Crucially, this literature search also revealed that these symptoms have long been regarded as "pseudo-hallucinations" (or "hallucination-like symptoms"). This concept was judged of poor scientific validity, inducing stigma for BPD patients in that it casts doubt on the authenticity of these experiences while disqualifying the related distress. This situation points out that research should focus more on understanding hallucinations in BPD than questioning their existence. Interestingly, recent comorbidity studies reopened a 40-year debate on the potential links that may exist between BPD and psychosis. Initially considered as a para-psychotic disorder, BPD was effectively redefined as an independent category by Otto F. Kernberg, leading to the DSM-III definition, excluding any psychotic symptom. However, hallucinations per se remain insufficient to diagnose schizophrenia, while comorbid substance use disorders as well as mood disorders, cannot explain all the hallucination occurrences in BPD. By referring to the "psychotic-reactivity-to-stress" framework, we proposed to understand hallucinations in BPD in relation to a hyperactivity of the hypothalamic-pituitary-adrenal axis and of the dopaminergic system under stress. Childhood trauma may have a central role in such a model. The prevalence of childhood trauma is high in BPD but this factor was also evidenced strongly linked with hallucinations in non-clinical populations. Comparisons are finally made and discussed between hallucinations occurring in BPD and those observed in posttraumatic stress disorder, another frequent comorbid disorder.

 

A study of psychotic symptoms in borderline personality disorder.
Pearse LJ1, Dibben C, Ziauddeen H, Denman C, McKenna PJ.

Patients with borderline personality disorder (BPD) report psychotic symptoms, but it has been questioned whether they are intrinsic to BPD. Thirty patients meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), criteria for BPD were drawn from a specialist personality disorder service. Exclusion criteria included a preexisting clinical diagnosis of nonaffective psychotic disorder. Participants underwent structured psychiatric interview using the Present State Examination (PSE), lifetime version. Approximately 60% of the patients reported psychoticsymptoms unrelated to drugs or affective disorder. Auditory hallucinations were the most common symptom (50%), which were persistent in the majority of cases. A fifth of the patients reported delusions, half of whom (three patients) also met DSM-IV criteria for schizophrenia, who were previously undiagnosed. The form of auditory hallucinations was similar to that in schizophrenia; the content was predominantly negative and critical. Persistent auditory hallucinations are intrinsic symptoms of BPD. This may inform current diagnostic criteria and have implications for approaches to treatment, both pharmacological and psychological. The presence of delusions may indicate a comorbid axis I disorder.  

Edited by iaawal
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I was diagnosed with schizoaffective bipolar type and BPD in the past.. I am now diagnosed with bipolar disorder and BPD. I am going to follow this to see because I'm curious and interested. I have had hallucinations and paranoia(on and off in the past, but now seemingly more on).

 

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