Hypothalamic‐pituitary‐adrenal axis functioning in borderline personality disorder: A meta‐analysis

HighlightsWe performed the first meta‐analysis on HPA axis functioning in BPD patients.BPD patients display blunted cortisol following psychosocial stress.BPD patients are characterized by elevated continuous cortisol output.Neither single nor pharmacological cortisol assessments differ for BPD patients. &NA; Borderline Personality Disorder (BPD) has been associated with altered hypothalamic‐pituitary‐adrenal (HPA) axis functioning. However, evidence is inconsistent. Therefore, the present series of meta‐analyses aimed to quantify HPA axis functioning in BPD patients based on singular and continuous cortisol assessments and measures of reactivity to pharmacological and psychosocial stress. Case‐control studies comparing adult BPD patients and healthy and clinical controls were considered for inclusion. The search resulted in 804 publications, of which 37 studies (k = 81; BPD n = 803, controls n = 1092) were included. Analyses were based on random effect models using standardized mean differences. BPD patients displayed elevated continuous cortisol output and blunted cortisol following psychosocial challenges. Singular cortisol assessments and cortisol after pharmacological challenges were not significantly different. Meta‐analyses were limited by inconsistent reporting in individual studies and small samples for some comparisons. Due to the debilitating nature of stress‐related symptoms in BPD, more research on elevated continuous cortisol output and blunted cortisol responses to psychosocial stress is warranted.

• Publication year

  2019

• Venue

  Neuroscience and Biobehavioral Reviews

• Publication date

  2019-01-01

• Fields of study

  Medicine, Psychology

• Identifiers
  DOI 10.1016/j.neubiorev.2018.11.008PMID 30500331
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

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