Serotonergic blunting to meta-chlorophenylpiperazine (m-CPP) highly correlates with sustained childhood abuse in impulsive and autoaggressive female borderline patients

Background: Disturbances of affect, impulse regulation and autoaggressive b ehavior which are all said to be related to an altered function of the cent ral serotonergic (5-HT) system, are prominent features of borderline person ality disorder (BPD). A high coincidence of childhood physical and sexual a buse is reported in these patients. Animal studies indicate that early, sus tained stress correlates with a dysfunctional central 5-HT system. Therefor e, we hypothesize that sustained traumatic stress in childhood affects the responsivity of the postsynaptic serotonergic system of traumatized BPD pat ients. Methods: Following Axis I, Axis II, and trauma assessment, a neuroendocrine challenge test was performed with the postsynaptic serotonergic agonist me ta-chlorophenylpiperazine (m-CPP) in 12 impulsive and autoaggressive female patients with BPD and 9 matched healthy volunteers. Results: The cortisol and prolactin responses to the m-CPP challenge in BPD patients were significantly lower compared to those in controls. Within th e group of patients with BPD, the net prolactin response showed a high inve rse correlation with the frequency of the physical (r = -.77) and sexual ab use (r = -.60). Conclusions: Our data suggest that severe and sustained traumatic stress in childhood affects the 5-HT system and especially 5-HT1A receptors, This fi nding confirms the data from animal research. The blunted prolactin respons e to m-CPP appears to be the result of severe traumatization and independen t of the BPD diagnosis. (C) 2000 Society of Biological Psychiatry.