Familial correlates of reduced central serotonergic system function in patients with personality disorders.
BACKGROUND
To test the hypothesis that evidence of reduced central serotonergic (5-HT) system function in probands with personality disorders is associated with an elevated morbid risk of psychopathological conditions putatively associated with 5-HT dysfunction in first-degree relatives of these probands.


METHODS
Data were collected during a study of the 5-HT correlates of behavior in male patients with DSM-III personality disorders conducted at a Veterans Affairs medical center. Probands in this study were selected from those patients who had undergone both a fenfluramine hydrochloride challenge and a family history assessment. Axis II diagnosis were made according to DSM-III criteria after a structured interview of the proband, using the Structured Interview for Diagnosing Personality Disorders, given by two raters and a similar interview with a knowledgeable informant by another rater.


RESULTS
Reduced prolactin responses to the 5-HT releasing/uptake inhibiting agent fenfluramine was associated with an elevated morbid risk of impulsive personality disorder traits in the first-degree relatives of patients with a primary DSM-III diagnosis of a personality disorder. Quantitative scores on assessments of impulsive aggression in the probands were not correlated with an increased morbid risk for impulsive personality disorder traits. A trend in the same direction was noted for affective personality disorder traits and alcoholism.


CONCLUSIONS
These results suggest that a central 5-HT system abnormality in probands is associated with an increased risk of impulsive aggression in their first-degree relatives, and that assessment of central 5-HT system function in probands may be a more sensitive parameter for identification of this familial trait than the presence of impulsive aggressive behaviors in the proband.
Coccaro
E F
EF
Department of Psychiatry, Medical College of Pennsylvania, Philadelphia.
Silverman
J M
JM
Klar
H M
HM
Horvath
T B
TB
Siever
L J
LJ
D000374:Aggression / Q000523:psychology; D000437:Alcoholism / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology; D005190:Family; D005277:Fenfluramine / Q000494:pharmacology; D006801:Humans; D007175:Impulsive Behavior / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology; D008297:Male; D010554:Personality Disorders / Q000175:diagnosis / Q000235:genetics* / Q000503:physiopathology; D011388:Prolactin / Q000097:blood; D011569:Psychiatric Status Rating Scales; D011985:Receptors, Serotonin / Q000235:genetics / Q000502:physiology; D012306:Risk; D012701:Serotonin / Q000235:genetics / Q000502:physiology*
D011985:Receptors, Serotonin; D005277:Fenfluramine; D012701:Serotonin; D011388:Prolactin