Borderline Personality Disorder and High-Risk for Psychosis Research: a Scoping Review

Introduction:  People at greatest risk for developing psychosis are characterized by a high prevalence of personality disorders (Boldrini et al., 2019). This research is aimed at mapping the literature on individuals presenting with borderline personality disorder (BPD) and at-risk for psychosis state and posing relevant research questions. Methods: Web of Science, Pubmed, and EBSO/APA PsycInfo databases were systematically searched from inception up to December 31st, 2022, including both original published research and grey literature for studies assessing at-risk for psychosis state (e.g., CHR-P, UHR, BS) or attenuated psychotic symptoms not meeting at-risk for psychosis inclusion criteria and BPD (e.g., employing the SCID) or subthreshold borderline personality pathology (e.g., using the SWAP). The study was conducted in accordance with the PRISMA extension guidelines for scoping reviews (Tricco et al., 2018). Results: Most retrieved studies were conducted in Western countries and Australia and focused on BPD in high-risk for psychosis samples. Topics explored included assessment, outcomes and transition to psychosis, transdiagnostic risk identification, mental health services for youth, and stress and trauma. Discussion: Future research should better define criteria for access to both at-risk for psychosis and personality disorders specialized clinical services. Moreover, randomized control trials aimed at evaluating need-based and psychological interventions for young CHR-P individuals with comorbid BPD are needed–in compliance with evidence-based recommendations. Finally, studies conducted with a transdiagnostic risk identification approach (Hartmann et al., 2021) could generate insight into additional early detection and intervention strategies.