Auditory Hallucinations in Borderline Personality Disorder and Schizophrenia: A Quantitative Comparison Using Patient Records

The phenomenological differences in auditory hallucinations between schizophrenia and borderline personality disorder (BPD) are unclear in the existing literature, in part due to underpowered studies and heterogeneous research populations that do not represent those in the acute clinical setting. This study addresses this by using patient records to compare auditory hallucinations at the point of clinical psychiatric assessment for 341 unique patients, 165 with BPD and 176 with schizophrenia. Patients with BPD were found to have more subjectively distressing and objectively negative hallucinations, as well as more command hallucinations. Furthermore, they possessed more insight and were less likely to incorporate hallucinations into delusions. These results support the hypothesis that, while descriptively similar, auditory hallucinations are interpreted differently between the two groups. This study also supports that electronic records of patient assessments are a feasible way to assess large numbers of reports of auditory hallucinations.