Hypothalamic-pituitary-adrenal axis functioning in borderline personality disorder: A meta-analysis

Drews, Elisa; Fertuck, Eric A.; Koenig, Julian; Kaess, Michael; Arntz, Arnoud (2019). Hypothalamic-pituitary-adrenal axis functioning in borderline personality disorder: A meta-analysis. Neuroscience & biobehavioral reviews, 96, pp. 316-334. Elsevier 10.1016/j.neubiorev.2018.11.008

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > University Psychiatric Services > University Hospital of Child and Adolescent Psychiatry and Psychotherapy
04 Faculty of Medicine > University Psychiatric Services > University Hospital of Child and Adolescent Psychiatry and Psychotherapy > Research Division

UniBE Contributor:

Koenig, Julian and Kaess, Michael

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0149-7634

Publisher:

Elsevier

Language:

English

Submitter:

Chantal Michel

Date Deposited:

18 Dec 2019 12:13

Last Modified:

26 May 2020 16:40

Publisher DOI:

10.1016/j.neubiorev.2018.11.008

PubMed ID:

30500331

BORIS DOI:

10.7892/boris.135652

URI:

https://boris.unibe.ch/id/eprint/135652

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