Borderline PD, cortisol, dhea

[Pat Quigley]

Interesting abstract on BPD and some of the adrenal hormones.

Journal of Psychiatric Research
Volume 41, Issue 12, December 2007, Pages 1019-1026 Epub 2006 Oct 9.

Basal cortisol and DHEA levels in women with borderline personality disorder

Jogems-Kosterman BJ, de Knijff DW, Kusters R, van Hoof JJ.
Institute of Mental Health Care, GGZ Oost Brabant, PO Box 632, 5340 AP Oss, The Netherlands. bjm.jogems@ggzoostbrabant.nl

Abstract

Previous research suggests that in borderline personality disorder (BPD) normal stress regulation, with a main role for cortisol, is disturbed. However, most studies were confounded by their lack of attention to co-morbidity.

Relevant patient characteristics such as depression, childhood abuse, posttraumatic stress disorder (PTSD) and copying styles were not systematically examined. Moreover, none of the studies incorporated dehydroepiandrosterone (DHEA), a hormone that can antagonize the effects of cortisol.

Hence, the present pilot study investigates the basic levels of cortisol and DHEA and the ratio (CDR) between the two hormones in BPD patients.

Twenty-two women with BPD and 22 healthy female controls provided two diurnal (8 a.m./8 p.m.) salivary samples.

Overall cortisol levels were not significantly increased in the patient group as a whole but only in those patients diagnosed with co-morbid PTSD and a history of childhood abuse.

The patients’ cortisol secretions decreased relatively less steep during the day than it did in the controls.

Surprisingly, morning DHEA levels were significantly higher in the patients than in the controls.

Moreover, the CDR showed a significantly larger and less favourable increase in the BPD group during the day.

In the patients lower levels of DHEA in the evening proved significantly related to a stronger tendency to avoid active problem solving and a lowered inclination to seek social support.

The current findings underline the relevance of cortisol and DHEA assessments and the need for further scrutiny of their interplay to foster our understanding of the biological basis of stress regulation in BPD.

PMID: 17028025 [PubMed – indexed for MEDLINE]

[DrMariano2]

@Pat Quigley 1314 wrote:

Previous research suggests that in borderline personality disorder (BPD) normal stress regulation, with a main role for cortisol, is disturbed. However, most studies were confounded by their lack of attention to co-morbidity.

What is interesting in this study is that higher cortisol levels and higher DHEA levels were found in women with borderline personality disorder and posttraumatic stress disorder with a history of childhood abuse.

This goes against what I find clinically and in the majority of the literature on posttraumatic stress disorder and childhood abuse – where cortisol levels are lower.

Thus, I question whether or not this study, itself, attended to confounding variables.

[Pat Quigley]

is it possible that early abuse and PTSD would leave one with high levels of cortisol earlier in life and then something akin to adrenal fatique as one ages?

[Author]

Posts