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首页> 外文期刊>The journal of clinical psychiatry >Childhood abuse and platelet tritiated-paroxetine binding in bulimia nervosa: implications of borderline personality disorder.
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Childhood abuse and platelet tritiated-paroxetine binding in bulimia nervosa: implications of borderline personality disorder.

机译：神经性贪食症中的儿童期虐待和血小板tri化帕罗西汀结合：边缘性人格障碍的含义。

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BACKGROUND: Co-occurrence of bulimia nervosa and borderline personality disorder has been attributed to shared factors, including childhood abuse and disturbances in central serotonin (5-hydroxytryptamine; 5-HT) mechanisms. To explore this notion, we conducted a controlled assessment of childhood abuse and 5-HT function in bulimics with and without borderline personality disorder. METHOD: Forty patients with bulimia nervosa, confirmed with the Eating Disorders Examination interview (14 with borderline personality disorder and 26 without), and 25 normal-eater controls were assessed for clinical symptoms (eating disturbances, mood lability, impulsivity, and dissociation) and childhood sexual and physical abuse. We also conducted tests of platelet tritiated-paroxetine binding in blood samples from 27 of the bulimics (11 with borderline personality disorder and 16 without) and 16 of the controls. RESULTS: Relative to normal eaters, bulimics showed greater affective instability, overall impulsivity, and a history of physical abuse. However, borderline bulimics alone showed elevated motor impulsivity, dissociation, and rates of sexual abuse. Paroxetine-binding tests indicated no differences attributable to comorbid borderline personality disorder, instead linking bulimia nervosa with or without borderline personality disorder to substantially reduced 5-HT transporter density. CONCLUSION: Results suggest relatively autonomous pathologic entities: one, relevant to bulimia nervosa, being associated with abnormal 5-HT transporter function and affective instability, but relatively independent of childhood sexual abuse; another, relevant to borderline personality disorder, onto which sexual abuse, dissociative symptoms, and behavioral impulsivity converge. We propose that abnormal 5-HT function may, however, constitute one basis for the frequent co-occurrence of bulimic and borderline disturbances.
机译：背景：神经性贪食症和边缘型人格障碍的并发归因于共同的因素，包括儿童期虐待和5-羟色胺（5-羟色胺; 5-HT）中枢机制紊乱。为了探索这一概念，我们对患有和不患有边缘人格障碍的暴食症儿童的虐待和5-HT功能进行了对照评估。方法：对40例神经性贪食症患者进行了饮食失调访谈（14例患有边缘性人格障碍，26例未患有边缘性人格障碍），并对25例饮食正常的对照进行了临床症状（饮食失调，情绪不稳，冲动和解体）的评估，童年时期的性虐待和身体虐待。我们还从27名暴食症患者（11名边缘性人格障碍患者和16名无边缘性人格障碍患者）和16名对照组的血液样本中进行了血小板tri化帕罗西汀的结合测试。结果：相对于正常饮食者，暴食症表现出更大的情感不稳定性，整体冲动性和身体虐待史。然而，仅边缘暴食症就显示出较高的运动冲动性，解离性和性虐待率。帕罗西汀结合试验表明没有可归因于合并性交界性人格障碍的差异，而是将患有或不存在交界性人格障碍的神经性贪食症与5-HT转运蛋白密度显着降低联系起来。结论：结果提示相对较独立的病理实体：其一与神经性贪食相关，与5-HT转运蛋白功能异常和情感不稳定有关，但相对于儿童性虐待而言相对独立。另一种与边缘型人格障碍有关，性虐待，分离症状和行为冲动在此交汇。我们建议，异常的5-HT功能可能，但是，构成脓毒症和边缘性干扰频繁并发的基础之一。

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