FC-013-007: HPT axis and exposure to interpersonal violence in childhood among women with borderline personality disorder

Session
FC-013: Childhood & Adolescent Disorders
Wednesday, June 1, 2011, 08:00 - 09:30, Terrace 1
Authors
Cave Sinai
Karolinska Institutet
Dep of Clinical Neuroscience
Co-Author(s)
Tatja Hirvikoski
Anna-Lena Nordström
Peter Nordström
Marie Åsberg
Jussi Jokinen

Objective
A relationship between thyroid autoimmune activity and borderline psychopathology (1) and a blunted thyrotropin (TSH) response to thyrotropin-releasing hormone (TRH) (2) has been observed in borderline personality disorder (BPD). The aim of the present study was to assess relationships between thyroid hormone measures and exposure to violence in childhood and during adult life in females with BPD.
Method
96 clinically euthyroid women with BPD diagnosis and at least 2 prior serious suicide attempts in their history, were assessed with the Karolinska Interpersonal Violence Scales (KIV scales) (3). The KIVS is a new structured interview, containing four subscales with concrete examples of exposure to violence and expressed violent behavior in childhood (between 6-14 years of age) and during adult life (15 years or older). Baseline thyroid functioning was evaluated by measuring plasma thyroid stimulating hormone (TSH), Transthyretin, free and bound Triiodothyronine (T3) and Thyroxine (T4) levels, as well as the FT3/FT4 (free T3/ free T4) ratio, by immunoassays.
Results
The FT3/FT4 ratio showed a significant negative correlation with exposure to violence as a child.
Conclusion
Altered thyroid activity, especially FT3/FT4 levels was associated with exposure to violence in childhood in suicide attempters. Severe childhood trauma-related stress may promote lasting altered thyroid levels and/or contribute to the development of psychopathology associated with BPD traits, coming to the notice of psychiatric care.


1) Antithyroid antibody-linked symptoms in borderline personality disorder. Geracioti TD Jr, Kling MA, Post RM, Gold PW. Endocrine. 2003 Jul;21(2):153-8.
2) The TRH test in patients wih borderline personality disorder. Garbutt JC, Loosen PT, Tipermas A, Prange AJ Jr. Psychiatry Res. 1983 Jun;9(2):107-13.
3) Karolinska Interpersonal Violence Scale predicts suicide in suicide attempters, Jokinen J, Forslund K, Ahnemark E, Gustavsson JP, Nordström P, Asberg MJ Clin Psychiatry. 2010 Aug;71(8):1025-32.