Michelle L West1,2, Ryan Guest1, Michelle Friedman-Yakoobian1,2; 1Harvard Medical School - Beth Israel Deaconess Medical Center, 2CEDAR Clinic @ Massachusetts Mental Health Center
Background: Research and clinical observation supports an overlap between clinical high risk (CHR) for psychosis and borderline personality disorder (BPD) symptoms. Adults with BPD may experience psychotic symptoms that appear phenomenologically similar to those in schizophrenia. Relatively less research has explored this overlap in CHR, characterized by newly developing symptoms. Initial evidence suggests that BPD symptoms are common in CHR samples (e.g., 64% with CHR plus likely or certain BPD pathology; Ryan et al., 2017) and may not be associated with risk of conversion (Thompson et al., 2012). This study aims to review relevant literature on CHR and BPD symptoms and present initial data from a specialized CHR clinic. Methods: The CEDAR Clinic collects assessment data, with these analyses focusing on the Structured Interview for Psychosis Risk Syndromes (SIPS) and a self-report measure of BPD symptoms (BSL-23). The BSL-23 has differentiated between BPD (M= 2.05, SD=.90) and other diagnoses including schizophrenia, but has not been investigated in CHR samples. Analyses included the subset (N=15) of clients who completed the BSL-23 and met broad CHR criteria. The sample size will increase with ongoing data collection. Results: BSL-23 scores were lower on average (M=1.41, SD=0.81) than BPD validation samples. BSL-23 scores significantly correlated with SIPS mean P symptoms scores (r=.661, p=.007), and were particularly associated with unusual thought content (r=.734, p=.002). Discussion: These analyses support that BPD and CHR symptoms overlap in a CHR clinical sample. Improved understanding of the overlap in CHR and BPD symptoms may inform diagnostic and treatment considerations.
