title: Hypothalamic pituitary thyroid axis and exposure to interpersonal violence in childhood among women with borderline personality disorder.
abstract: BACKGROUND
  A relationship between exposure to sexual violence and thyroid hormone alterations has been observed among women with posttraumatic stress disorder (PTSD). Women with borderline personality disorder (BPD) report a high estimate of childhood trauma.
  
  
  OBJECTIVE
  The aim of the present study was to assess relationships between thyroid hormone measures and exposure to violence in childhood in women with BPD.
  
  
  METHODS
  A total of 92 clinically euthyroid women with BPD (53% with comorbid PTSD) diagnosis and at least two prior suicide attempts were assessed with the Karolinska Interpersonal Violence Scales (KIVS). The KIVS contains four subscales with concrete examples of exposure to violence and expressed violent behavior in childhood (aged 6-14 years) and during adult life (15 years or older). Baseline thyroid function was evaluated by measuring plasma free and bound triiodothyronine (FT3 and T3), thyroxine (FT4 and T4), and thyroid-stimulating hormone (TSH) with immunoassays. The FT3/FT4 ratio was used to estimate peripheral deiodination. Plasma cortisol was also assessed.
  
  
  RESULTS
  Sixty-seven percent of patients reported medium high or high level of exposure to interpersonal violence as a child. The FT3/FT4 ratio showed a significant negative correlation with exposure to violence as a child. Patients with PTSD had significantly higher plasma cortisol levels. An ad hoc analysis revealed that the correlation between KIVS exposure to interpersonal violence as a child and FT3/FT4 ratio was significant only in patients with comorbid PTSD. Altered thyroid activity, especially FT3/FT4, levels was associated with exposure to violence in childhood in women with BPD.
  
  
  CONCLUSIONS
  Severe childhood trauma-related stress may promote lasting altered thyroid levels and/or contribute to the development of psychopathology associated with BPD traits or PTSD.
authors: Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden.
authors: Cave
authors: C
authors: Sinai
authors: Department of Children's and Women's Health, Center for Neurodevelopmental Disorders at Karolinska Institutet (KIND), Stockholm, Sweden.
authors: Tatja
authors: T
authors: Hirvikoski
authors: Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden.
authors: Anna-Lena
authors: AL
authors: Nordström
authors: Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden.
authors: Peter
authors: P
authors: Nordström
authors: Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden.
authors: Asa
authors: A
authors: Nilsonne
authors: Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden.
authors: Alexander
authors: A
authors: Wilczek
authors: Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
authors: Marie
authors: M
authors: Asberg
authors: Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden.
authors: Jussi
authors: J
authors: Jokinen
keywords: HPT axis; borderline personality disorder; childhood adverse events; childhood maltreatment; interpersonal violence; stress; thyroid hormones; trauma