Increased testosterone levels and cortisol awakening responses in patients with borderline personality disorder: gender and trait aggressiveness matter

Juliane Rausch; Andrea Gäbel; Krisztina Nagy; Nikolaus Kleindienst; Sabine C Herpertz; Katja Bertsch

doi:10.1016/j.psyneuen.2015.02.002

Increased testosterone levels and cortisol awakening responses in patients with borderline personality disorder: gender and trait aggressiveness matter

Psychoneuroendocrinology. 2015 May:55:116-27. doi: 10.1016/j.psyneuen.2015.02.002. Epub 2015 Feb 12.

Authors

Juliane Rausch¹, Andrea Gäbel¹, Krisztina Nagy¹, Nikolaus Kleindienst², Sabine C Herpertz¹, Katja Bertsch³

Affiliations

¹ Department for General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Germany.
² Department of Psychosomatic Medicine, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany.
³ Department for General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Germany. Electronic address: Katja.bertsch@med.uni-heidelberg.de.

PMID: 25796037
DOI: 10.1016/j.psyneuen.2015.02.002

Abstract

Background: Borderline personality disorder (BPD) is characterized by antagonism, negative affectivity, disinhibition, and impairments in interpersonal functioning, including enhanced impulsive aggression. Interpersonal dysfunctions may be related to alterations in endocrine systems. The current study investigated alterations in basal activity of the hypothalamus-pituitary-gonadal (HPG) reproductive and the hypothalamus-pituitary-adrenal (HPA) stress system in BPD patients and their association to anger-related aggression with a particular focus on effects of gender and comorbid conditions of depression and posttraumatic stress disorder (PTSD).

Method: Saliva testosterone levels as well as cortisol awakening responses were assessed in 55 medication-free female and male patients with BPD and compared to 47 gender-, age-, and intelligence-matched healthy volunteers. In addition, analyses controlling for current depression and PSTD and bivariate correlations between testosterone and cortisol levels on the one hand and anger and aggressiveness on the other hand were performed.

Results: The results revealed increased saliva testosterone levels in female and male patients with BPD as well as elevated cortisol awakening responses in female, but not male patients with BPD compared to healthy volunteers. Cortisol awakening responses were positively related to anger and aggressiveness in female patients with BPD, but no associations were found with testosterone levels.

Conclusion: In line with previous reports, the present results suggest endocrine alterations in BPD which may be associated with interpersonal impairments, such as increased anger-related aggressive behavior and could have implications for the development of new (psychopharmaco-) therapeutic interventions that may help to restore the alterations in the HPA and HPG systems.

Keywords: Androgen metabolism; Endocrinology; Hypothalamus–pituitary–adrenal axis; Hypothalamus–pituitary–gonadal axis; Reproductive system; Stress.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Aggression / physiology*
Aggression / psychology
Anger / physiology
Borderline Personality Disorder / metabolism*
Borderline Personality Disorder / psychology
Case-Control Studies
Circadian Rhythm / physiology
Depressive Disorder / metabolism
Depressive Disorder / psychology
Female
Gonads / metabolism*
Humans
Hydrocortisone / metabolism*
Hypothalamo-Hypophyseal System / metabolism*
Male
Middle Aged
Personality
Pituitary-Adrenal System / metabolism*
Saliva / chemistry
Sex Factors
Stress Disorders, Post-Traumatic / metabolism
Stress Disorders, Post-Traumatic / psychology
Testosterone / metabolism*
Young Adult

Substances

Testosterone
Hydrocortisone