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The amphetamine challenge test in patients with borderline disorder
S C Schulz1, J Cornelius, P M Schulz
1Schizophrenia Research Branch, National Institute of Mental Health, Rockville, MD 20857.
The American Journal of Psychiatry
|July 1, 1988
Summary
Amphetamine administration revealed that borderline personality disorder patients may be prone to psychosis. Some patients worsened, while others improved, highlighting the use of pharmacological probes in understanding personality disorders.
Area of Science:
- Psychopharmacology
- Psychiatry
- Neuroscience
Background:
- Borderline personality disorder (BPD) is associated with emotional dysregulation and interpersonal difficulties.
- Patients with BPD may exhibit heightened sensitivity to dopaminergic stimulation.
- Psychosis is a potential concern in individuals with severe personality disorders.
Purpose of the Study:
- To investigate the hypothesis that patients with borderline personality disorder (BPD) are susceptible to psychosis after dopamine agonist administration.
- To examine the effects of amphetamine, a psychopharmacological probe, on psychiatric symptoms in BPD patients.
- To differentiate symptom responses based on comorbid diagnoses.
Main Methods:
- Amphetamine was administered as a psychopharmacological probe to sixteen patients diagnosed with borderline personality disorder (BPD).
- Psychiatric symptoms were assessed using the Brief Psychiatric Rating Scale (BPRS) and its subfactors (activation, thought disturbance).
- Patients were categorized based on BPD alone versus BPD with comorbid schizotypal personality disorder.
Main Results:
- Amphetamine administration led to significant increases in mean total BPRS scores, activation, and thought disturbance factors in the BPD sample.
- Patients with comorbid schizotypal and borderline personality disorders showed transient worsening of symptoms.
- Conversely, patients with only borderline personality disorder experienced transient improvement in symptoms.
Conclusions:
- Pharmacological probes, such as amphetamine, are valuable tools for understanding the neurobiological underpinnings of DSM-III Axis II disorders.
- Dopamine system sensitivity may differ in BPD patients, potentially influenced by comorbid conditions.
- These findings suggest distinct psychopharmacological profiles within the spectrum of personality disorders.