Pain sensitivity is reduced in borderline personality disorder, but not in posttraumatic stress disorder and bulimia nervosa.
BACKGROUND
Several studies revealed reduced pain sensitivity in patients suffering from borderline personality disorder (BPD) under baseline and stress conditions. To establish whether these findings are specific for BPD, we compared pain thresholds in patients with BPD, posttraumatic stress disorder (PTSD), bulimia nervosa, and healthy controls.


METHODS
The study included 76 female subjects: 16 patients with BPD, 16 patients with PTSD, 20 patients with bulimia nervosa and 24 healthy controls. Heat and cold pain thresholds were assessed under baseline and stress conditions, using a contact thermode. Mental stress was induced by the Paced Auditory Serial Addition Task.


RESULTS
Under baseline conditions, pain thresholds in patients with BPD were significantly higher compared to healthy controls. Patients with PTSD and bulimia nervosa did not show significant differences in pain thresholds compared to healthy controls. Under stress conditions, the difference between BPD patients and healthy controls became even more prominent, whereas the results in the other patient groups remained insignificant.


CONCLUSIONS
Our results support the hypothesis that reduced pain sensitivity is a prominent feature of BPD, which may differentiate this disorder from other stress-related psychiatric conditions.
Schmahl
Christian
C
Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany. christian.schmahl@zi-mannheim.de
Meinzer
Miriam
M
Zeuch
Andrea
A
Fichter
Manfred
M
Cebulla
Marian
M
Kleindienst
Nikolaus
N
Ludäscher
Petra
P
Steil
Regina
R
Bohus
Martin
M
D000328:Adult; D001883:Borderline Personality Disorder / Q000503:physiopathology* / Q000523:psychology; D052018:Bulimia Nervosa / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D006801:Humans; D010147:Pain Measurement; D017288:Pain Threshold / Q000502:physiology*; D011569:Psychiatric Status Rating Scales; D013313:Stress Disorders, Post-Traumatic / Q000503:physiopathology* / Q000523:psychology; D013315:Stress, Psychological / Q000503:physiopathology; D055815:Young Adult