Serotonergic blunting to meta-chlorophenylpiperazine (m-CPP) highly correlates with sustained childhood abuse in impulsive and autoaggressive female borderline patients.
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-HT(1A) 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.
Rinne
T
T
De Geestgronden Institute of Mental Health Care, Bennebroek, The Netherlands.
Westenberg
H G
HG
den Boer
J A
JA
van den Brink
W
W
D000293:Adolescent; D000328:Adult; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism*; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007175:Impulsive Behavior / Q000209:etiology*; D008875:Middle Aged; D010879:Piperazines / Q000097:blood; D011388:Prolactin / Q000378:metabolism; D011569:Psychiatric Status Rating Scales; D016728:Self-Injurious Behavior / Q000209:etiology*; D012701:Serotonin / Q000378:metabolism*; D017366:Serotonin Receptor Agonists / Q000097:blood; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism*
D010879:Piperazines; D017366:Serotonin Receptor Agonists; D012701:Serotonin; D011388:Prolactin; C015068:1-(3-chlorophenyl)piperazine; D006854:Hydrocortisone