Background: Disturbances of affect, impulse regulation and autoaggressive behavior which are all said to be related to an altered function of the central serotonergic (5-HT) system, are prominent features of borderline personality disorder (BPD). A high coincidence of childhood physical and sexual abuse is reported in these patients. Animal studies indicate that early, sustained stress correlates with a dysfunctional central 5-HT system. Therefore, we hypothesize that sustained traumatic stress in childhood affects the responsivity of the postsynaptic serotonergic system of traumatized BPD patients.
Methods: Following Axis I, Axis II, and trauma assessment, a neuroendocrine challenge test was performed with the postsynaptic serotonergic agonist meta-chlorophenylpiperazine (m-CPP) in 12 impulsive and autoaggressive female patients with BPD and 9 matched healthy volunteers.
Results: The cortisol and prolactin responses to the m-CPP challenge in BPD patients were significantly lower compared to those in controls. Within the group of patients with BPD, the net prolactin response showed a high inverse correlation with the frequency of the physical (r = -.77) and sexual abuse (r = -.60).
Conclusions: Our data suggest that severe and sustained traumatic stress in childhood affects the 5-HT system and especially 5-HT1A receptors, This finding confirms the data from animal research. The blunted prolactin response to m-CPP appears to be the result of severe traumatization and independent of the BPD diagnosis. (C) 2000 Society of Biological Psychiatry.
|Number of pages||9|
|Publication status||Published - 15-Mar-2000|
- borderline personality disorder
- childhood abuse/trauma
- m-chlorophenylpiperazine Cm-CPP)
- serotonin (5-HT)
- MAJOR DEPRESSION
- SEXUAL ABUSE
- NEUROENDOCRINE RESPONSE
- CORTISOL RESPONSES
- PROLACTIN RESPONSE
- 5-HT2C RECEPTORS
- PHYSICAL ABUSE