边缘型人格障碍的下丘脑-垂体-肾上腺轴功能：一项荟萃分析。
Hypothalamic-pituitary-adrenal axis functioning in borderline personality disorder: A meta-analysis.
机构信息
Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany; Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands; New York State Psychiatric Institute, Columbia University, College of Physicians and Surgeons, New York, United States.
The City College and Graduate Center of the City University of New York, New York, United States; New York State Psychiatric Institute, Columbia University, College of Physicians and Surgeons, New York, United States.
出版信息
Neurosci Biobehav Rev. 2019 Jan;96:316-334. doi: 10.1016/j.neubiorev.2018.11.008. Epub 2018 Nov 27.
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.
边缘型人格障碍（BPD）与下丘脑-垂体-肾上腺（HPA）轴功能改变有关。然而，证据并不一致。因此，本系列荟萃分析旨在基于单一和连续皮质醇评估以及对药物和心理社会应激的反应性测量，定量 BPD 患者的 HPA 轴功能。纳入了比较成年 BPD 患者与健康和临床对照组的病例对照研究。检索结果产生了 804 篇出版物，其中 37 项研究（k=81；BPD n=803，对照组 n=1092）被纳入。分析基于随机效应模型，使用标准化均数差异。BPD 患者表现出连续皮质醇输出升高和心理社会挑战后皮质醇反应迟钝。单一皮质醇评估和药物挑战后皮质醇无显著差异。荟萃分析受到个别研究报告不一致和某些比较样本量小的限制。由于 BPD 与应激相关症状的致残性质，需要更多研究升高的连续皮质醇输出和对心理社会应激的皮质醇反应迟钝。
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