Soloff Paul H, Kelly Thomas M, Strotmeyer Stephen J, Malone Kevin M, Mann J John
Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA, USA.
Psychiatry Res. 2003 Jul 15;119(1-2):11-24. doi: 10.1016/s0165-1781(03)00100-8.
Behavioral impulsivity in borderline personality disorder (BPD) is associated with indices of diminished central serotonergic function, independent of suicidal behavior, depression or alcohol use disorder. Many of these studies have been conducted among males in specialized settings. Studies of BPD females, who constitute the majority of BPD patients, are generally conducted in community settings and report inconsistent findings. We studied gender differences in behavioral impulsivity and the prolactin response to D,L-fenfluramine (FEN) in BPD subjects in a community setting. A FEN challenge study was conducted with 64 BPD subjects (20 male, 44 female), and 57 controls (36 male, 21 female). Axis I and II disorders, including BPD, and suicidal histories were assessed by structured interviews. Controls were free of Axis I and II disorders. Impulsivity and aggression were assessed by the Buss-Durkee Hostility Inventory, Barratt Impulsiveness Scale, Minnesota Multiphasic Personality Inventory-Psychopathic Deviate subscale, and the Brown-Goodwin Lifetime History of Aggression. Male, but not female, BPD subjects had significantly diminished prolactin responses compared to controls. Impulsivity and aggression each predicted prolactin responses. A significant effect of BPD diagnosis on prolactin response was eliminated when impulsivity was co-varied. Impulsivity and aggression were inversely related to delta-prolactin and peak-prolactin responses among male but not female subjects. Gender differences in central serotonergic function may contribute to variations in impulsivity in BPD.
边缘型人格障碍（BPD）中的行为冲动性与中枢5-羟色胺能功能降低的指标相关，与自杀行为、抑郁或酒精使用障碍无关。这些研究大多是在专门环境中的男性中进行的。构成BPD患者大多数的女性BPD患者的研究通常是在社区环境中进行的，且结果不一致。我们在社区环境中研究了BPD患者行为冲动性和催乳素对D，L-芬氟拉明（FEN）反应的性别差异。对64名BPD患者（20名男性，44名女性）和57名对照者（36名男性，21名女性）进行了FEN激发试验。通过结构化访谈评估了包括BPD在内的轴I和轴II障碍以及自杀史。对照者无轴I和轴II障碍。通过Buss-Durkee敌意量表、巴拉特冲动性量表、明尼苏达多相人格调查表-精神病态偏差分量表以及Brown-Goodwin攻击行为终身史来评估冲动性和攻击性。与对照者相比，男性BPD患者而非女性BPD患者的催乳素反应显著降低。冲动性和攻击性各自都能预测催乳素反应。当对冲动性进行协变量分析时，BPD诊断对催乳素反应的显著影响被消除。在男性而非女性受试者中，冲动性和攻击性与催乳素变化量和催乳素峰值反应呈负相关。中枢5-羟色胺能功能的性别差异可能导致BPD患者冲动性的变化。
