title: Serotonergic blunting to meta-chlorophenylpiperazine (m-CPP) highly correlates with sustained childhood abuse in impulsive and autoaggressive female borderline patients.
abstract: 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.
authors.affiliation: De Geestgronden Institute of Mental Health Care, Bennebroek, The Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: Rinne
authors.forename: H G
authors.initials: HG
authors.lastname: Westenberg
authors.forename: J A
authors.initials: JA
authors.lastname: den Boer
authors.forename: W
authors.initials: W
authors.lastname: van den Brink
mesh_terms: 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*
chemical_list: D010879:Piperazines; D017366:Serotonin Receptor Agonists; D012701:Serotonin; D011388:Prolactin; C015068:1-(3-chlorophenyl)piperazine; D006854:Hydrocortisone