DEPRESSIVE RESPONSE TO PHYSOSTIGMINE CHALLENGE IN BORDERLINE PERSONALITY-DISORDER PATIENTS

The purpose of this study was to examine the relationship between mood and hormonal responses to cholinergic challenge with physostigmine in order to assess cholinergic system responsiveness in borderline perso nality disorder (BPD) patients, other non-BPD personality disorder pat ients, and normal controls. Thirty-four personality disorder patients, 10 of whom met criteria for BPD and 24 of whom met criteria for other , non-borderline, personality disorders, and II normal controls partic ipated in a double blind, placebo controlled physostigmine challenge p aradigm. The Profile of Mood States depression subscale (POMS-D) self report measure was obtained at baseline and following the physostigmin e or placebo infusions. A repeated measures ANOVA of POMS-D scores in placebo and drug conditions indicated a significantly greater depressi ve response in the total cohort of personality disorder patients than in the normal comparison group (p < 0.05). However, the depressive res ponse to physostigmine was significantly greater in BPD patients, but not other personality disorder patients, compared to normal controls ( p < 0.05). There was a correlation between the peak placebo-corrected depressive response to physostigmine and a group of BPD traits related to affective instability but not a group of BPD traits related to imp ulsivity. There was no correlation in any group between mood response to physostigmine and changes in plasma cortisol, prolactin, or growth hormone, or to nausea or other side effects following physostigmine in fusion. These data suggest that there is an association between BPD an d acute depressive responses to physostigmine challenge, and that the cholinergic system may be involved in the regulation of affect in Axis II disorders. Published by Elsevier Science Inc.