Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK.
Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK.
Curr Psychiatry Rep. 2021 Apr 9;23(5):30. doi: 10.1007/s11920-021-01236-w.
We review the recent evidence suggesting that circadian rhythm disturbance is a common unaddressed feature of borderline personality disorder (BPD); amelioration of which may confer substantial clinical benefit. We assess chronobiological BPD studies from a mechanistic and translational perspective and highlight opportunities for the future development of this hypothesis.
The emerging circadian phenotype of BPD is characterised by a preponderance of comorbid circadian rhythm sleep-wake disorders, phase delayed and misaligned rest-activity patterns and attenuated amplitudes of usually well-characterised circadian rhythms. Such disturbances may exacerbate symptom severity, and specific maladaptive personality dimensions may produce a liability towards extremes in chronotype. Pilot studies suggest intervention may be beneficial, but development is limited. Endogenous and exogenous circadian rhythm disturbances appear to be common in BPD. The interface between psychiatry and chronobiology has led previously to novel efficacious strategies for the treatment of psychiatric disorders. We believe that better characterisation of the circadian phenotype in BPD will lead to a directed biological target for treatment in a condition where there is a regrettable paucity of accessible therapies.
我们回顾了最近的证据，表明昼夜节律紊乱是边缘型人格障碍（BPD）常见且未被解决的特征之一；改善这种紊乱可能会带来显著的临床获益。我们从机制和转化的角度评估了关于 BPD 的生物钟研究，并强调了这一假说未来发展的机会。
BPD 的新兴昼夜节律表型的特征是存在较多共病的昼夜节律睡眠-觉醒障碍、相位延迟和不规律的休息-活动模式以及通常特征明显的昼夜节律幅度减弱。这些紊乱可能会使症状严重程度恶化，特定的适应不良人格维度可能会导致对昼夜时型极端的倾向。初步研究表明干预可能是有益的，但发展受到限制。内源性和外源性的昼夜节律紊乱在 BPD 中似乎很常见。精神病学和生物钟学之间的界面以前为治疗精神疾病提供了新的有效策略。我们相信，更好地描述 BPD 的昼夜节律表型将为这种治疗方法有限的疾病提供一个有针对性的生物靶点。
