[Auditory verbal hallucinations in patients with borderline personality disorder]. / Auditieve verbale hallucinaties bij patiënten met een borderline-persoonlijkheidsstoornis.

BACKGROUND: Traditionally, auditory verbal hallucinations (AVH) experienced by patients with a borderline personality disorder (BPD) are considered to be rare, to have a 'pseudo'-quality, and to cause little distress. AIM: To provide an overview of studies of the prevalence and phenomenological characteristics of AVHs in patients with a BPD, and of the ensuing degree of suffering. METHOD: We performed a systematic literature search using PubMed and the Ovid database. RESULTS: 27% of patients with a BPD experience AVH. Phenomenologically, these percepts are indistinguishable from those experienced by patients with a schizophrenia spectrum disorder. Hallucinations in several modalities were present in 50% of the patients with BPD. The mean time-span in which AVH were experienced was 17 years, the mean frequency was several minutes per day. The degree of suffering was high and the patient's life was interrupted to a moderate degree. CONCLUSION: AVH and other hallucinations are common in BPD. We advise clinicians to inquire directly whether patients experience them and to provide treatment whenever possible. However, one of the problems is, that evidence-based treatment methods such as antipsychotics, cognitive-behavioural therapy and transcranial magnetic stimulation have not yet been studied systematically for this specific patient group.

IDH1 mutations in low-grade astrocytomas predict survival but not response to temozolomide.

BACKGROUND: Mutations in isocitrate dehydrogenase 1 and 2 (IDH1 and IDH2) have been implicated in tumorigenesis of gliomas. Patients with high-grade astrocytomas with IDH1 or IDH2 mutations were reported to have a better survival, but it is unknown if this improved survival also holds for low-grade astrocytoma and whether these mutations predict outcome to specific treatment. METHODS: We retrospectively investigated the correlation of IDH1 and IDH2 mutations with overall survival and response to temozolomide in a cohort of patients with dedifferentiated low-grade astrocytomas treated with temozolomide at the time of progression after radiotherapy. RESULTS: IDH1 mutations were present in 86% of the 49 progressive astrocytomas. No mutations in IDH2 were found. Presence of IDH1 mutations were early events and significantly improved overall survival (median survival 48 vs 98 months), but did not affect outcome of temozolomide treatment. CONCLUSION: These results indicate that IDH1 mutations identify a subgroup of gliomas with an improved survival, but are unrelated to the temozolomide response.