边缘型人格障碍中的地塞米松抑制试验——创伤后应激障碍的影响
Dexamethasone suppression test in borderline personality disorder--effects of posttraumatic stress disorder.
作者信息
Lange Wolfgang, Wulff Hella, Berea Christina, Beblo Thomas, Saavedra Anamaria Silva, Mensebach Christoph, Wingenfeld Katja, Driessen Martin
机构信息
Center of Psychiatry and Psychological Medicine, Gilead Hospital Bethel, Bielefeld, Germany.
出版信息
Psychoneuroendocrinology. 2005 Oct;30(9):919-23. doi: 10.1016/j.psyneuen.2005.02.009.
BACKGROUND
Divergent findings of hypothalamic-pituitary-adrenal (HPA) axis functioning in borderline personality disorder (BPD) may be caused by a different degree of comorbid posttraumatic stress disorder (PTSD), in which alterations of the HPA axis are well known. Here we investigate alterations of the HPA axis in BPD patients with and without comorbid PTSD compared to healthy controls. Considering previous findings current major depression (MDD) was taken into account as a confounding variable.
METHODS
Apart from clinical assessment the 0.5 mg dexamethasone suppression test (DST) was performed in 21 female borderline patients and 23 healthy controls.
RESULTS
Twelve BPD patients suffered from comorbid PTSD. Relative suppression (%) did not differ between healthy controls and the total BPD group, but BPD patients with comorbid PTSD showed increased suppression compared to those without. Comorbid MDD was not associated with suppression.
CONCLUSIONS
Our results do not indicate a dysfunction of the HPA axis in BPD. However, comorbid PTSD seems to be associated with a relative hypersuppression in the 0.5 mg DST.
背景
边缘型人格障碍（BPD）患者下丘脑 - 垂体 - 肾上腺（HPA）轴功能的不同研究结果，可能是由不同程度的共病创伤后应激障碍（PTSD）导致的，其中HPA轴的改变是众所周知的。在此，我们研究了合并和未合并PTSD的BPD患者与健康对照相比HPA轴的改变情况。考虑到之前的研究结果，将当前的重度抑郁症（MDD）作为一个混杂变量纳入研究。
方法
除了临床评估外，对21名女性边缘型患者和23名健康对照进行了0.5毫克地塞米松抑制试验（DST）。
结果
12名BPD患者患有共病PTSD。健康对照与BPD患者总组之间的相对抑制率（%）没有差异，但合并PTSD的BPD患者与未合并者相比，抑制率增加。共病MDD与抑制率无关。
结论
我们的结果并未表明BPD患者存在HPA轴功能障碍。然而，共病PTSD似乎与0.5毫克DST中的相对高抑制有关。
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