ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Personality Disorders
This article is part of the Research TopicBorderline Personality Disorder: Insights into Etiology, Diagnosis, and Treatment StrategiesView all 7 articles
Sexual hallucinations and delusions in borderline personality disorder
Provisionally accepted
Rosemarij J.B. van Veen1,2
Jan Dirk Blom1,3,4*Emma H.C. van Rooijen5
Ingmar Franken2
Christina W. Slotema1,2- 1Parnassia Psychiatric Institute, The Hague, Netherlands
- 2Erasmus Universiteit Rotterdam, Rotterdam, Netherlands
- 3Universiteit Leiden, Leiden, Netherlands
- 4Rijksuniversiteit Groningen, Groningen, Netherlands
- 5Leids Universitair Medisch Centrum, Leiden, Netherlands
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Introduction: Sexual hallucinations have lifetime prevalence rates of 0.4% in the general population and up to 44% in schizophrenia spectrum disorders. For borderline personality disorder (BPD) these rates are unknown. We therefore studied prevalence rates of sexual hallucinations and delusions in this group, as well as their phenomenological characteristics and their connection with childhood trauma. Methods: We carried out a cross-sectional study among outpatients with BPD, using the Sexual Hallucinations and Delusions Questionnaire (SHDQ), the Psychotic Symptom Rating Scales–Auditory Verbal Hallucinations (PSYRATS-AVH) and the Childhood Trauma Questionnaire (CTQ). Results: Among 81 people interviewed, we found a lifetime prevalence rate of 59.3% for sexual hallucinations, and 49.4% for sexual delusions. For the last month these rates were 36.0% and 31.0%, respectively. In this group somatic, visual, tactile and auditory sexual hallucinations were more common than olfactory and gustatory ones. Childhood trauma was reported by all participants, with emotional abuse and sexual abuse showing the strongest link with sexual hallucinations and delusions. Discussion: Sexual hallucinations and delusions are very common in people with BPD. They may well explain (part of) the emotional and behavioral aspects considered characteristic of BPD. Our finding that childhood trauma was reported by all participants indicates that more research is needed to explore the impact of trauma in this specific population. We also provide recommendations for clinical practice, including treatment options.
Keywords: Borderline Personality Disorder, childhood trauma, multimodal hallucination, Prevalence, sexual abuse, sexual delusion, sexual hallucination
Received: 19 Nov 2025; Accepted: 29 Jan 2026.
Copyright: © 2026 van Veen, Blom, van Rooijen, Franken and Slotema. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jan Dirk Blom
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