Time to put aside the false dichotomy between personality disorders and psychotic symptoms

Author:

Leclerc Philippe1ORCID,Gamache Dominick23ORCID,Cailhol Lionel4ORCID

Affiliation:

1. Faculté d'éducation Université de Sherbrooke Sherbrooke Quebec Canada

2. Département de psychologie Université du Québec à Trois‐Rivières Trois‐Rivières Quebec Canada

3. CERVO Brain Research Centre Québec City Québec Canada

4. Département de psychiatrie Centre intégré universitaire de santé et de services sociaux de l'Est‐de‐l'Île‐de‐Montréal Montréal Québec Canada

Abstract

AbstractUnlike internalizing and externalizing symptoms, psychotic symptoms (e.g., hallucinations, delusions) are manifestations of personality disorders (PDs) that are more controversial and poorly understood. This leaves clinicians with very little guidance for clinical practice, especially for diagnosis. What is more, most reviews have focused strictly on the links between psychotic symptoms and the categorically defined borderline PD, which contrasts with the growing movement that emphasizes a dimensional perspective (especially in psychology). Thus, the objectives of this critical review will be to (a) expose typical cases where PDs and psychotic symptoms might cooccur; (b) assess the state of scientific knowledge surrounding PD and psychotic symptoms; and (c) provide clinicians and researchers with recommendations to keep the field moving forward. We conclude that researchers and clinicians should move past the false “PD or psychosis” dichotomy since they often cooccur, avoid (as far as possible) making psychotic symptoms an exclusion criterion in PD research to enhance ecological validity, and consider dimensional PD diagnosis as a potential unifying solution to the dilemma posed by this cooccurrence.

Publisher

Wiley

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