What is Borderline Schizophrenia?

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.

Symptoms of Borderline Schizophrenia

Given that “borderline schizophrenia” is not a formal diagnosis, it’s difficult to establish specific symptoms. It does help to understand the symptoms of schizophrenia, as the term can refer to an individual who shows some symptoms of the disease.

Two or more of the following symptoms are present for a significant portion of time during a one-month period.1

  • Delusions
  • Hallucinations
  • Disorganized speech
  • Grossly disorganized or catatonic behavior
  • Negative symptoms (i.e. diminished emotional expression)
  1. Level of functioning in work, interpersonal connection, or self-care is impaired by the symptoms for a significant portion of time. Change in functioning is significant compared to previous level of functioning.
  2. Continuous signs of the disturbance for a six-month period. This period can include at least one month of active symptoms followed by residual periods or periods marked by negative symptoms.
  3. Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out.
  4. The disturbance is not attributed to drug use or another medical condition.
  5. If there is a history of autism spectrum disorder or a childhood communication disorder, a diagnosis of schizophrenia is only made if there are prominent delusions or hallucinations.
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Schizophrenia and Borderline Personality Disorder (BPD)

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.

Symptoms of Borderline Personality Disorder (BPD)

Given the comorbidity between schizophrenia and BPD, it can be useful to understand the symptoms of BPD.

BPD includes a pervasive pattern of instability of interpersonal relationships, self-image, and affects, marked impulsivity, beginning in early adulthood as indicated by at least five (or more) of the following symptoms:

  • Frantic efforts to avoid real or imagined abandonment
  • A pattern of unstable and intense relationships characterized by alternating extremes of idealization and devaluation
  • Identity disturbance characterized by persistently unstable self-image or sense of self
  • Impulsivity in at least two areas that are self-damaging: spending, sex, substance abuse, reckless driving, binge eating)
  • Affective instability due to reactivity of mood (intense episodic dysphoria, irritability, or anxiety)
  • Chronic feelings of emptiness
  • Inappropriate, intense anger or difficulty controlling anger
  • Transient, stress-related paranoid ideation or severe dissociative symptoms

During periods of extreme stress, paranoid ideation or dissociative symptoms can occur. While these symptoms are generally insufficient to require an additional diagnosis, they can parallel some active symptoms of schizophrenia.

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Seek Clarification

BPD is a very different diagnosis than schizophrenia, though the two can co-exist. While BPD is characterized by a pattern of instability in interpersonal relationships; schizophrenia is characterized by a range of cognitive, behavioral, and emotional dysfunctions.

If you, or someone you know, are described as having “borderline schizophrenia”, it could point toward mild symptoms, unclear symptoms, or a combination of symptoms. The best thing you can do is to seek clarification from a licensed professional.

The best way to find a treatment plan that works for you is to understand your symptoms. A second opinion or a follow-up visit to ask specific questions is always a good idea.

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Last Updated: May 14, 2021