title: Increased testosterone levels and cortisol awakening responses in patients with borderline personality disorder: gender and trait aggressiveness matter.
abstract: BACKGROUND
  Borderline personality disorder (BPD) is characterized by antagonism, negative affectivity, disinhibition, and impairments in interpersonal functioning, including enhanced impulsive aggression. Interpersonal dysfunctions may be related to alterations in endocrine systems. The current study investigated alterations in basal activity of the hypothalamus-pituitary-gonadal (HPG) reproductive and the hypothalamus-pituitary-adrenal (HPA) stress system in BPD patients and their association to anger-related aggression with a particular focus on effects of gender and comorbid conditions of depression and posttraumatic stress disorder (PTSD).
  
  
  METHODS
  Saliva testosterone levels as well as cortisol awakening responses were assessed in 55 medication-free female and male patients with BPD and compared to 47 gender-, age-, and intelligence-matched healthy volunteers. In addition, analyses controlling for current depression and PSTD and bivariate correlations between testosterone and cortisol levels on the one hand and anger and aggressiveness on the other hand were performed.
  
  
  RESULTS
  The results revealed increased saliva testosterone levels in female and male patients with BPD as well as elevated cortisol awakening responses in female, but not male patients with BPD compared to healthy volunteers. Cortisol awakening responses were positively related to anger and aggressiveness in female patients with BPD, but no associations were found with testosterone levels.
  
  
  CONCLUSIONS
  In line with previous reports, the present results suggest endocrine alterations in BPD which may be associated with interpersonal impairments, such as increased anger-related aggressive behavior and could have implications for the development of new (psychopharmaco-) therapeutic interventions that may help to restore the alterations in the HPA and HPG systems.
authors: Department for General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Germany.
authors: Juliane
authors: J
authors: Rausch
authors: Department for General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Germany.
authors: Andrea
authors: A
authors: Gäbel
authors: Department for General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Germany.
authors: Krisztina
authors: K
authors: Nagy
authors: Department of Psychosomatic Medicine, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany.
authors: Nikolaus
authors: N
authors: Kleindienst
authors: Department for General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Germany.
authors: Sabine C
authors: SC
authors: Herpertz
authors: Department for General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Germany. Electronic address: Katja.bertsch@med.uni-heidelberg.de.
authors: Katja
authors: K
authors: Bertsch
mesh_terms: D000293:Adolescent; D000328:Adult; D000374:Aggression / Q000502:physiology* / Q000523:psychology; D000786:Anger / Q000502:physiology; D001883:Borderline Personality Disorder / Q000378:metabolism* / Q000523:psychology; D016022:Case-Control Studies; D002940:Circadian Rhythm / Q000502:physiology; D003866:Depressive Disorder / Q000378:metabolism / Q000523:psychology; D005260:Female; D006066:Gonads / Q000378:metabolism*; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010551:Personality; D010913:Pituitary-Adrenal System / Q000378:metabolism*; D012463:Saliva / Q000737:chemistry; D012737:Sex Factors; D013313:Stress Disorders, Post-Traumatic / Q000378:metabolism / Q000523:psychology; D013739:Testosterone / Q000378:metabolism*; D055815:Young Adult
chemical_list: D013739:Testosterone; D006854:Hydrocortisone
keywords: Androgen metabolism; Endocrinology; Hypothalamus–pituitary–adrenal axis; Hypothalamus–pituitary–gonadal axis; Reproductive system; Stress