title: Impulsivity, gender, and response to fenfluramine challenge in borderline personality disorder.
abstract: Behavioral impulsivity in borderline personality disorder (BPD) is associated with indices of diminished central serotonergic function, independent of suicidal behavior, depression or alcohol use disorder. Many of these studies have been conducted among males in specialized settings. Studies of BPD females, who constitute the majority of BPD patients, are generally conducted in community settings and report inconsistent findings. We studied gender differences in behavioral impulsivity and the prolactin response to D,L-fenfluramine (FEN) in BPD subjects in a community setting. A FEN challenge study was conducted with 64 BPD subjects (20 male, 44 female), and 57 controls (36 male, 21 female). Axis I and II disorders, including BPD, and suicidal histories were assessed by structured interviews. Controls were free of Axis I and II disorders. Impulsivity and aggression were assessed by the Buss-Durkee Hostility Inventory, Barratt Impulsiveness Scale, Minnesota Multiphasic Personality Inventory-Psychopathic Deviate subscale, and the Brown-Goodwin Lifetime History of Aggression. Male, but not female, BPD subjects had significantly diminished prolactin responses compared to controls. Impulsivity and aggression each predicted prolactin responses. A significant effect of BPD diagnosis on prolactin response was eliminated when impulsivity was co-varied. Impulsivity and aggression were inversely related to delta-prolactin and peak-prolactin responses among male but not female subjects. Gender differences in central serotonergic function may contribute to variations in impulsivity in BPD.
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA, USA. soloffph@msx.upmc.edu
authors.forename: Paul H
authors.initials: PH
authors.lastname: Soloff
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Kelly
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Strotmeyer
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Malone
authors.forename: J John
authors.initials: JJ
authors.lastname: Mann
mesh_terms: D000328:Adult; D000374:Aggression / Q000523:psychology; D015992:Body Mass Index; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000378:metabolism*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000378:metabolism*; D004334:Drug Administration Schedule; D004562:Electrocardiography; D005260:Female; D005277:Fenfluramine / Q000008:administration & dosage / Q000494:pharmacology*; D006791:Hostility; D006801:Humans; D008950:MMPI; D008297:Male; D011388:Prolactin / Q000378:metabolism*; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*; D017678:Sex Distribution; D013405:Suicide / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
chemical_list: D005277:Fenfluramine; D011388:Prolactin; D017367:Selective Serotonin Reuptake Inhibitors