"Borderline Personality Disorder": Hormones, Cutting & Despair"

Borderline personality disorder (BPD) is a serious and highly prevalent (5.9%) psychiatric disorder. The core features of BPD are dissociation, mood lability, self-harm, anger, and problems with self-identity. A common antecedent for many women with this condition is early life trauma. Current psychological treatments are expensive and difficult for patients to access, whilst no clearly designated pharmacotherapy is known to be specifically effective to treat BPD. Therefore, there is an urgent need for a new approach to this disorder.

The noted correlation of high rates of polycystic ovarian syndrome in women with BPD appears to be related to dysregulation of both the HPG and HPA axes.

The glutamatergic system, in the CNS, particularly, the N-methyl-D-aspartic acid (NMDA) subtype receptor, is increasingly recognised for its role in BPD, with recent neurobiological research linking stress, immune system alterations and neuroendocrine dysregulation observed in BPD with glutamate excitotoxicity.

Estradiol treatment is noted to be a neuroprotective approach and may assist women with cyclical fluctuation in their BPD symptoms.

In this presentation, new approaches to the aetiology and treatment of this prevalent and poorly understood psychiatric condition will be discussed.