Bogudzińska Bogna, Maciaszek Julian, Stańczykiewicz Bartłomiej, Bielawski Tomasz, Dybek Agnieszka, Alejnikowa Julia, Pawłowski Tomasz, Misiak Błażej
Department of Psychiatry, Wroclaw Medical University, 50-367 Wroclaw, Poland.
Division of Consultation Psychiatry and Neuroscience, Department of Psychiatry, Wroclaw Medical University, 50-367 Wroclaw, Poland.
Brain Sci. 2024 Oct 20;14(10):1040. doi: 10.3390/brainsci14101040.
BACKGROUND/OBJECTIVES: The dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis has been associated with various mental disorders. One of the most commonly described parameters of HPA axis functioning is the cortisol awakening response (CAR). To date, few studies have been conducted on the relationship between personality disorders and CAR. The present study aimed to compare the CAR between individuals with personality disorders and healthy controls. Moreover, the study aimed to assess the association of CAR with cognitive biases and psychopathological symptoms in people with personality disorders.
A total of 43 individuals with personality disorders and 45 healthy controls were enrolled. Participants completed questionnaires measuring the severity of depressive symptoms, anxiety, cognitive biases, and psychotic-like experiences. Cortisol levels were measured in four morning saliva samples: immediately after awakening, and after 15, 30, and 45 min.
A significantly lower CAR was found among individuals with personality disorders, even after adjustment for age, sex, and the level of education. However, the receiver operating characteristic (ROC) curve analysis showed a relatively low area under the curve (AUC = 0.362). Furthermore, a significant negative correlation was observed between the CAR and the level of external attribution bias among individuals with personality disorders. No significant associations of the CAR with psychopathological symptoms and other cognitive biases were observed.
Findings from this study indicate that the HPA axis activity might be altered in personality disorders. However, the clinical utility of this observation needs further studies in larger samples. External attribution might be related to the HPA axis alterations in this population.
背景/目的：下丘脑-垂体-肾上腺（HPA）轴功能失调与多种精神障碍有关。HPA轴功能最常描述的参数之一是皮质醇觉醒反应（CAR）。迄今为止，关于人格障碍与CAR之间关系的研究较少。本研究旨在比较人格障碍患者与健康对照者的CAR。此外，该研究旨在评估人格障碍患者中CAR与认知偏差和精神病理症状之间的关联。
共纳入43名人格障碍患者和45名健康对照者。参与者完成了测量抑郁症状、焦虑、认知偏差和类精神病体验严重程度的问卷。在早晨采集的四份唾液样本中测量皮质醇水平：觉醒后即刻、15分钟后、30分钟后和45分钟后。
即使在对年龄、性别和教育水平进行调整后，人格障碍患者的CAR仍显著较低。然而，受试者工作特征（ROC）曲线分析显示曲线下面积相对较低（AUC = 0.362）。此外，在人格障碍患者中，CAR与外部归因偏差水平之间存在显著负相关。未观察到CAR与精神病理症状和其他认知偏差之间存在显著关联。
本研究结果表明，人格障碍患者的HPA轴活动可能发生改变。然而，这一观察结果的临床实用性需要在更大样本中进行进一步研究。外部归因可能与该人群的HPA轴改变有关。
