Hypothalamic-pituitary-adrenal axis functioning in borderline personality disorder: A meta-analysis

NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS

卷:96

Article

Drews, Elisa^1,2,5  Fertuck, Eric A.^3,4,5  Koenig, Julian^1,6  Kaess, Michael^1,6  Arntz, Arnoud² 

[1] Heidelberg Univ, Ctr Psychosocial Med, Dept Child & Adolescent Psychiat, Sect Translat Psychobiol Child & Adolescent Psych, Heidelberg, Germany

[2] Univ Amsterdam, Dept Clin Psychol, Amsterdam, Netherlands

[3] CUNY City Coll, New York, NY 10031 USA

[4] CUNY, Grad Ctr, New York, NY USA

[5] Columbia Univ, Coll Phys & Surg, New York State Psychiat Inst, New York, NY USA

[6] Univ Bern, Univ Hosp Child & Adolescent Psychiat & Psychothe, Bern, Switzerland

关键词: Borderline personality disorder;    Hypothalamic-pituitary-adrenal axis;    Cortisol;    Stress response;    Meta-analysis;   

DOI  :  10.1016/j.neubiorev.2018.11.008

来源: Elsevier

【 摘 要 】

Borderline Personality Disorder (BPD) has been associated with altered hypothalamic-pituitary-adrenal (HPA) axis functioning. However, evidence is inconsistent. Therefore, the present series of meta-analyses aimed to quantify HPA axis functioning in BPD patients based on singular and continuous cortisol assessments and measures of reactivity to pharmacological and psychosocial stress. Case-control studies comparing adult BPD patients and healthy and clinical controls were considered for inclusion. The search resulted in 804 publications, of which 37 studies (k = 81; BPD n = 803, controls n = 1092) were included. Analyses were based on random effect models using standardized mean differences. BPD patients displayed elevated continuous cortisol output and blunted cortisol following psychosocial challenges. Singular cortisol assessments and cortisol after pharmacological challenges were not significantly different. Meta-analyses were limited by inconsistent reporting in individual studies and small samples for some comparisons. Due to the debilitating nature of stress-related symptoms in BPD, more research on elevated continuous cortisol output and blunted cortisol responses to psychosocial stress is warranted.

【 授权许可】

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