title: Effects of cortisol on memory in women with borderline personality disorder: role of co-morbid post-traumatic stress disorder and major depression.
abstract: BACKGROUND
  Stress and cortisol administration are known to have impairing effects on memory retrieval in healthy humans. These effects are reported to be altered in patients with major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) but they have not yet been investigated in borderline personality disorder (BPD).
  
  
  METHODS
  In a placebo-controlled cross-over study, 71 women with BPD and 40 healthy controls received either placebo or 10 mg of hydrocortisone orally before undertaking a declarative memory retrieval task (word list learning) and an autobiographical memory test (AMT). A working memory test was also applied.
  
  
  RESULTS
  Overall, opposing effects of cortisol on memory were observed when comparing patients with controls. In controls, cortisol had impairing effects on memory retrieval whereas in BPD patients cortisol had enhancing effects on memory retrieval of words, autobiographical memory and working memory. These effects were most pronounced for specificity of autobiographical memory retrieval. Patients with BPD alone and those with co-morbid PTSD showed this effect. We also found that co-morbid MDD influenced the cortisol effects: in this subgroup (BPD + MDD) the effects of cortisol on memory were absent.
  
  
  CONCLUSIONS
  The present results demonstrate beneficial effects of acute cortisol elevations on hippocampal-mediated memory processes in BPD. The absence of these effects in patients with co-morbid MDD suggests that these patients differ from other BPD patients in terms of their sensitivity to glucocorticoids (GCs).
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité University Berlin, Campus Benjamin Franklin, Berlin, Germany. katja.wingenfeld@charite.de
authors.forename: K
authors.initials: K
authors.lastname: Wingenfeld
authors.forename: M
authors.initials: M
authors.lastname: Driessen
authors.forename: K
authors.initials: K
authors.lastname: Terfehr
authors.forename: N
authors.initials: N
authors.lastname: Schlosser
authors.forename: S Carvalho
authors.initials: SC
authors.lastname: Fernando
authors.forename: C
authors.initials: C
authors.lastname: Otte
authors.forename: T
authors.initials: T
authors.lastname: Beblo
authors.forename: C
authors.initials: C
authors.lastname: Spitzer
authors.forename: B
authors.initials: B
authors.lastname: Löwe
authors.forename: O T
authors.initials: OT
authors.lastname: Wolf
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000893:Anti-Inflammatory Agents / Q000494:pharmacology*; D001883:Borderline Personality Disorder / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D015897:Comorbidity; D018592:Cross-Over Studies; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000494:pharmacology*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D008568:Memory / Q000187:drug effects*; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D010919:Placebos; D011569:Psychiatric Status Rating Scales; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*
chemical_list: D000893:Anti-Inflammatory Agents; D010919:Placebos; D006854:Hydrocortisone