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Can Someone Have Schizophrenia and Borderline Personality Disorder?

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I have a client that I am trying to help get in touch with mental health services. He has previously been diagnosed with schizophrenia, PTSD, and borderline personality disorder. I was recently told that it isn’t possible to have both schizophrenia and borderline personality disorder. Is this true, and if so what is the reasoning?

Can Someone Have Schizophrenia and Borderline Personality Disorder?

Answered by on -

A.

I am not aware of any “rule” that says that individuals diagnosed with schizophrenia cannot be diagnosed with borderline personality disorder.

Psycom’s website states, “Schizophrenia and borderline personality disorder (BPD) can share symptoms. One study found that both patients with schizophrenia and patients with BPD experience hearing voices. The difference between the two being that paranoid delusions occurred in less than one-third of patients with BPD, compared with two-thirds in schizophrenia. The study also found that auditory hallucinations are common in both populations. According to the results of this study, schizophrenia and BPD frequently co-exist. Accurate diagnosis of either or both conditions plays an important role in establishing an effective treatment plan.

As stated on Psycom’s website, “The term “borderline schizophrenia” does not refer to an established diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. It is sometimes used, however, to refer to an individual who meets some, but not all, of the criterion for schizophrenia or to refer to parallel symptoms of borderline personality disorder and schizophrenia. As noted previously, schizophrenia and borderline personality disorder (BPD) can share symptoms: one study found that both patients with schizophrenia and patients with BPD experience hearing voices. The difference between the two being that paranoid delusions occurred in less than one-third of patients with BPD, compared with two-thirds in schizophrenia. The study also found that auditory hallucinations are common in both populations. According to the results of this study, schizophrenia and BPD frequently co-exist, however, accurate diagnosis of either or both conditions plays an important role in establishing an effective treatment plan. While BPD is characterized by a pattern of instability in interpersonal relationships; schizophrenia is characterized by a range of cognitive, behavioral, and emotional dysfunctions.”

Perhaps the person you learned this information from incorrectly believes that borderline personality disorder means that the individual is “bordering” between neurosis and psychosis. Under this theory, a person could not be schizophrenic because they have not crossed the psychosis threshold (i.e. their bordering between neurosis and psychosis), a required feature of a schizophrenia diagnosis. “Borderline” does not mean that an individual is teetering between neurosis and psychosis, although some believe this. People with borderline personality disorder display certain symptoms such as mood and self-image instability, difficulty engaging in relationships, anger and depression, “all or nothing thinking”, and so forth. A person with schizophrenia can display these aforementioned symptoms, in addition to psychosis, as well as some of the other symptoms of schizophrenia. The two disorders are not mutually exclusive meaning that if a person has schizophrenia, then he or she cannot be diagnosed with borderline personality disorder. From my understanding, it is possible for an individual to have both disorders simultaneously. It may not be common, per se, but it’s still possible.

Lastly, to further illustrate BPD and schizophrenia similarities and differences, study.com summarizes, “People with any personality disorder (such as BPD) tend to lose the normal flexibility of personality. They are relatively coherent, and can think for themselves. Their thoughts make sense, more or less, and they can interact at some level of normalcy. Their problem is that their minds are stuck in a sort of psychological rut. In the case of the BPD sufferers, that rut is right on the edge of complete instability. Their relationships tend to be intense and difficult, because their thoughts and emotional reactions make intimacy difficult, yet they cling desperately to the people who are willing to spend time with them. Schizophrenia is not a personality disorder, in the way we described BPD. People who suffer from its various forms are losing touch with reality, altogether. Instead of having personalities that cause difficulty by becoming rigid and inflexible, the schizophrenic personality begins to dissolve. The BPD individual may walk a strange ‘road’ of inconsistencies in his life, but the schizophrenic may walk no ‘road’ at all. His day is often spent in constant distractions, confusions, distortions, and contortions caused by the fragmented activities happening in the various areas of the brain.”

I hope this information helps. Thank you for writing.

Can Someone Have Schizophrenia and Borderline Personality Disorder?

This article has been updated from the original version, which was originally published here on August 25, 2008.

Kristina Randle, Ph.D., LCSW

Kristina Randle, Ph.D., LCSW is a licensed psychotherapist and Assistant Professor of Social Work and Forensics with extensive experience in the field of mental health. She works in private practice with adults, adolescents and families. Kristina has worked in a large array of settings including community mental health, college counseling and university research centers.

APA Reference
Randle, K. (2019). Can Someone Have Schizophrenia and Borderline Personality Disorder?. Psych Central. Retrieved on August 19, 2019, from https://psychcentral.com/ask-the-therapist/2018/08/25/can-someone-have-schizophrenia-and-borderline-personality-disorder/
Scientifically Reviewed
Last updated: 20 Jun 2019
Last reviewed: By a member of our scientific advisory board on 20 Jun 2019
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