Abstract
Borderline personality disorder (BPD) is a serious psychiatric condition characterized by dysfunctional relations, abnormal social behavior, and high morbidity. Many studies have implicated abnormal oxytocinergic system as a causative factor of behavioral dysregulation in BPD patients. The objective of this review is to provide a comprehensive analysis of the association of oxytocin with the pathogenesis of BPD and its possible role as a therapeutic agent. Our review indicates that a combination of genetic and environmental factors causes BPD patients to have lower baseline levels of oxytocin, leading to increased activation of the amygdala. This results in defective cognition of social stimuli, leading to abnormal behaviors like affective instability, unresolved attachment, and emotional dysregulation. Clinical trials conducted on BPD patients using intranasal oxytocin have shown both prosocial and trust-lowering effects. The effects of oxytocin depend upon various patient characteristics like the history of childhood trauma and the nature of attachment. Even though evidence of oxytocin's role in modulating behavior in BPD patients already exists, further studies are required to more clearly elaborate on this role to fully explore oxytocin's potential as a therapeutic agent.
Highlights
BackgroundPeople suffering from personality disorders form the major share of patients receiving psychiatric care, and among all personality disorders, borderline personality disorder (BPD) is the most commonly treated issue along with schizotypal personality disorder [1]
This review focuses on the latest literature on the role of oxytocin, its genetics, receptor polymorphism, and how it interacts with the environment and early abuse to cause BPD
It has been reported that childhood maltreatment in the AA/AG subgroup leads to more empathy towards psychological pain while the GG subgroup remained unaffected by childhood maltreatment; it is hypothesized that the oxytocin receptor (OXTR) gene has a role in disproportionately increased empathy towards psychological pain in BPD patients as compared to controls, with this disproportionality leading to disturbed relatedness
Summary
BackgroundPeople suffering from personality disorders form the major share of patients receiving psychiatric care, and among all personality disorders, borderline personality disorder (BPD) is the most commonly treated issue along with schizotypal personality disorder [1]. Affective instability refers to multiple mood changes within a single day, ranging from euphoria to dysphoria, and anger outbursts followed by feelings of guilt often targeted toward caregivers [3]. This affective instability was the most common criterion present at baseline as well as after two years in clinically diagnosed BPD patients as per a study [4]. BPD patients face stigma in society but in psychiatric and mental health units as well. These patients have several negative connotations attached to them, which lead to mental health clinicians having a negative attitude toward them; a minority of clinicians prefer to not work with BPD patients [5]
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