Biological nature of depressive symptoms in borderline personality disorder: endocrine comparison to recurrent brief and major depression

Fuente, José Manuel De la; Bobes, Julio; Vizuete, Coro; Mendlewicz, Julien

doi:10.1016/s0022-3956(01)00056-5

Cited by 21 publications

(13 citation statements)

References 33 publications

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“…The RBD has another ‘overlap of symptoms’ or in other words ‘comorbidity’: a substantial number of patients with RBD can be diagnosed as having borderline personality disorder (BPD) (23). In the study of De la Fuente et al.…”

Section: Discussionmentioning

confidence: 99%

A psychopathological study into the relationship between attention deficit hyperactivity disorder in adult patients and recurrent brief depression

Heßlinger

Elst

Mochan

et al. 2003

Acta Psychiatr Scand

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Section: Discussionmentioning

confidence: 99%

A psychopathological study into the relationship between attention deficit hyperactivity disorder in adult patients and recurrent brief depression

Heßlinger

Elst

Mochan

et al. 2003

Acta Psychiatr Scand

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“…Moreover, although no studies have examined differences in biological emotional reactivity in BPD versus MDD, research examining other aspects of biologically-indexed emotional dysfunction in BPD and MDD suggests higher resting cortisol levels in BPD (but not MDD) versus controls [58], as well as hypo-suppression of cortisol in response to the dexamethasone suppression test in MDD but not BPD [59]. Finally, extant research provides initial support for distinct patterns of self-reported emotion dysregulation in BPD and MDD pathology.…”

Section: Introductionmentioning

confidence: 99%

Characterizing emotional dysfunction in borderline personality, major depression, and their co-occurrence

Dixon‐Gordon

Weiss

Tull

et al. 2015

Comprehensive Psychiatry

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This research aimed to characterize patterns of emotional reactivity and dysregulation in borderline personality, depression, and their co-occurrence. In Study 1, 488 young adult women from the community were categorized into four groups based on self-reported major depressive disorder (MDD) and borderline personality disorder (BPD) symptoms (Low BPD/Low MDD; Low BPD/High MDD; High BPD/Low MDD; High BPD/High MDD). Immediate and prolonged subjective emotional reactivity to a laboratory stressor were assessed, and participants completed self-report and behavioral measures of emotion dysregulation. Study 2 extended these findings, examining emotional reactivity and dysregulation in a clinical population of 176 substance dependent patients with diagnoses of BPD and MDD and including a biological index of emotional reactivity. Results revealed greater prolonged fear reactivity in the High BPD/High MDD (vs. Low BPD/Low MDD) group in Study 1, and greater prolonged anxiety and negative affect reactivity in both High BPD groups (vs. Low BPD/Low MDD and Low BPD/High MDD groups) in Study 2 (but no differences in cortisol reactivity). Results also demonstrated greater subjective (but not behavioral) emotion dysregulation in the High BPD/High MDD (vs. Low BPD/Low MDD) group in Study 1 and both High BPD groups (vs. both Low BPD groups) in Study 2. Finally, the High BPD/High MDD group reported greater difficulties controlling impulsive behaviors compared with all other groups in Study 1 and the Low BPD groups in Study 2. Findings suggest that BPD pathology (but not MDD pathology alone) is characterized by greater prolonged emotional (especially anxiety/fear-related) reactivity and heightened emotion dysregulation.

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“…BPD patients without concomitant MD have not shown abnormality in endocrine tests (De la Fuente et al, 2002). In the subcategory proposed, the hypothalamic pituitary axis would probably not be altered, or at least not in the same way than in MD.…”

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confidence: 83%

“…Diverse laboratory data registered in the last few years have guided to propose that the depressive symptoms in BPD have a distinct biological substrate than those in the nonborderline depressive illness (De la Fuente et al, 2002;. Recent receptor studies have found the hippocampal 5HT(2A) receptor binding, which is decreased in MD (Mintun et al, 2004), is increased in BPD with binding values being related to comorbid MD but not to depressed mood (Soloff et al, 2007).…”

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confidence: 99%

Editorial: Issues for DSM-V: I) Including Biological Variables To Objectively Comfort the Clinical Diagnosis of Borderline Personality Disorder and II) Proposing a New Subcategory To Be Included in the Criteria Sets for Further Study

Fuente

Bobes

2009

Int J Soc Psychiatry

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Borderline personality disorder (BPD) is a serious chronic condition which may lead to a poor quality of life and carries a considerable risk of comorbidity and suicide. The syndrome has been acknowledged and investigated in psychiatry for at least seventy years. The DSM-IV gives a panel of nine symptoms and manifestations for its diagnosis, but not taking into account neurobiological and objective issues.The issue of whether BPD should be considered as a discrete condition, as the edge of a dimensional state ranging from 'almost normal' personalities to clearly pathological ones or as a hybrid of traits and symptomatic behaviors (McGlashan, 2005) seems to be important to correctly diagnose our patients and is a corner stone in the Research Agenda for DSM-V. The pathophysiology of BPD is very important because this is the progress which will probably lead to the development of effective treatments. Several investigators have shown some laboratory and objective clinical fi ndings in BPD as normality in endocrinological dynamic tests (De La Fuente et al., 2002), alterations in sleep-EEG parameters (De la Fuente et al., 2004), disturbed regional brain glucose metabolism (De la Fuente et al., 1997), abnormal scalp EEGs (De la Fuente et al., 1998) and an extremely high prevalence of neurologic soft signs (De la Fuente et al., 2006). These facts probably refl ect common underlying non focal nervous system failure and hypothalamic-pituitary-adrenal axis normality in BPD.However, these fi ndings are not pathognomonic of the condition and BPD is diagnosed according to DSM-IV when a patient shows at least fi ve symptoms out of a list of nine. First & Zimmerman (2006) propose that biological variables can aid to identify the patients as compared to the criteria used now to defi ne them. For this the objective signs and facts found in BPD could be included as diagnostic criteria in the DSM-V. Scalp wake EEG, the clinical exploration for neurologic soft signs, sleep EEG recordings and the two endocrine tests, dexamethasone suppression and TRH stimulation, which are cheap, not invasive and have shown to be linked to the diagnosis of BPD could be incorporated in a diagnostic weighting construct with these variables as additional score items. This would have at least three advantages over the present criteria: fi rstly, a part of the diagnosis of BPD would become objective, secondly, having these parameters would attach physiopathological information to the diagnosis and thirdly, the laboratory information and objective International Journal of Social Psychiatry.

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Biological nature of depressive symptoms in borderline personality disorder: endocrine comparison to recurrent brief and major depression

Cited by 21 publications

References 33 publications

A psychopathological study into the relationship between attention deficit hyperactivity disorder in adult patients and recurrent brief depression

A psychopathological study into the relationship between attention deficit hyperactivity disorder in adult patients and recurrent brief depression

Characterizing emotional dysfunction in borderline personality, major depression, and their co-occurrence

Editorial: Issues for DSM-V: I) Including Biological Variables To Objectively Comfort the Clinical Diagnosis of Borderline Personality Disorder and II) Proposing a New Subcategory To Be Included in the Criteria Sets for Further Study

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