Borderline kişilik bozukluğunda dürtüsellik ve saldırganlık ile kan ghrelin, D vitamini, lipit düzeyleri arasındaki ilişki

Year 2023, Volume: 48 Issue: 2, 644 - 653, 02.07.2023

Sema Baykara , Şahin Karakaş , Şuheda Kaya , Gülay Taşcı , Selda Telo

https://doi.org/10.17826/cumj.1243820

Abstract

Amaç: Bu çalışmada Borderline Kişilik Bozukluğu (BKB)’da impulsivite ve agresyonun serum ghrelin, lipit ve D vitamini düzeyleriyle ilişkisinin araştırırılması planlandı.
Gereç ve Yöntem: Çalışmaya BKB tanılı 30 kadın hasta ve 30 sağlıklı kontrol dâhil edildi. Katılımcılara Sosyodemografik ve Klinik Bilgi Formu, Beck Anksiyete Envanteri, Beck Depresyon Envanteri, Barratt Dürtüsellik Ölçeği-Kısa Form (BIS-11-KF), Buss-Perry Saldırganlık Ölçeği (BPSÖ) uygulandı.
Bulgular: Ghrelin, kolesterol ve trigliserit seviyeleri BKB hastalarında daha yüksekti, D Vitamini, HDL ve LDL açısından anlamlı farklılık yoktu. Ghrelin ile lipitler ve D vitamini arasında ilişki tespit edilmedi. BIS-11 ve BPSÖ puanlarında, gruplar arasında anlamlı farklılık vardı. Ghrelin ile BIS-11 puanları arasında pozitif bir ilişki bulundu. D vitamini ile BPSÖ alt boyutu olan ‘öfke’ puanı arasında pozitif bir ilişki bulundu. Trigliserit ile BPSÖ alt boyutu olan ‘sözel saldırganlık’ puanı arasında negatif bir ilişki bulundu.
Sonuç: BKB, hastane başvurularının çok olduğu, komorbid durumların sık eşlik ettiği, sosyal ilişkileri ve işlevselliği bozan ve tedavisi güç olan bir bozukluktur. Ghrelin regülasyonu, Vitamin D ve lipit düzeylerinin düzenlenmesi hastalığın tedavisinde ve klinik takibinde klinisyenlere fayda sağlayabilir

Keywords

Borderline kişilik bozukluğu, impulsif davranış, agresyon, ghrelin, vitamin D, lipitler

Supporting Institution

FUBAP

Thanks

FUBAP'a katkılarından dolayı teşekkür ederiz

Relationship between impulsivity, aggression and blood ghrelin, vitamin D, lipids levels in borderline personality disorder

Abstract

Purpose: This study aimed to investigate the correlations between impulsivity and aggression, and blood ghrelin, lipids, and vitamin D levels in Borderline Personality Disorder (BPD).
Materials and Methods: Thirty female patients with BPD and 30 healthy controls were included to the study. Sociodemographic Data Form, Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Barratt Impulsivity Scale Short Form (BIS-11-SF), Buss-Perry Aggression Questionnaire (BPAQ) were applied.
Results: Ghrelin, cholesterol, and triglyceride (TG) levels were higher in BPD patients (p=0.013, p=0.042, p=0.019, respectively); however, there was no significant difference between the groups based on vitamin D, High-density lipoprotein (HDL) and Low-density lipoprotein (LDL) levels. There was no correlation between ghrelin, and lipid and vitamin D levels. The BIS-11 and BPAQ scores were higher in BPD group. A positive correlation was determined between ghrelin and BIS-11 scores. A positive correlation was found between vitamin D and ‘anger’ subscale score of BPAQ. A negative correlation was identified between triglyceride and the ‘verbal aggression’ subscale score of BPAQ.
Conclusion: BPD is a disorder with several hospital admissions, frequent comorbid conditions, problematic social relationships, and functionality, and the treatment is quite difficult. Regulation of Ghrelin, vitamin D and lipid levels could assist clinicians in the treatment and clinical follow-up of the disease.

Keywords

Borderline personality disorder;, impulsive behavior;, ; aggression, ghreline, vitamin d, lipids

References

• APA. Diagnostic and Statistical Manual Of Mental Disorders (DSM-5®). 5th ed. ed. Arlington, VA: American Psychiatric Publishing; 2013.
• Widiger TA, Weissman MM. Epidemiology of borderline personality disorder. Hosp. Community Psychiatry. 1991;42:1015-21.
• Siever LJ, Torgersen S, Gunderson JG, Livesley WJ, Kendler KS. The borderline diagnosis III: identifying endophenotypes for genetic studies. Biol Psychiatry. 2002;51:964-8.
• Kurt E, Güler Ö, Ozbulut O, Altınbaş K, Işingör M, Serteser M et al. Evaluation of serum ghrelin and leptin levels in suicide attempters. J Psychophysiol. 2008;22:76-80.
• Virkkunen M. Serum cholesterol in antisocial personality. Neuropsychobiology. 1979;5:27-30.
• Dawe S, Loxton NJ. The role of impulsivity in the development of substance use and eating disorders. Neurosci Biobehav Rev. 2004;28:343-51.
• Schag K, Schonleber J, Teufel M, Zipfel S, Giel KE. Food-related impulsivity in obesity and binge eating disorder--a systematic review. Obes Rev. 2013;14:477-95.
• Asakawa A, Inui A, Kaga T, Yuzuriha H, Nagata T, Fujimiya M et al. A role of ghrelin in neuroendocrine and behavioral responses to stress in mice. Neuroendocrinology. 2001;74:143-7.
• Kojima M, Hosoda H, Date Y, Nakazato M, Matsuo H, Kangawa K. Ghrelin is a growth-hormone-releasing acylated peptide from stomach. Nature. 1999;402:656-60.9.
• Hansson C, Shirazi RH, Näslund J, Vogel H, Neuber C, Holm G et al. Ghrelin influences novelty seeking behavior in rodents and men. PloS One. 2012;7:e50409.
• Skibicka KP, Dickson SL. Ghrelin and food reward: the story of potential underlying substrates. Peptides. 2011;32:2265-73.
• van den Akker K, Jansen A, Frentz F, Havermans RC. Impulsivity makes more susceptible to overeating after contextual appetitive conditioning. Appetite. 2013;70:73-80.
• Velazquez-Sanchez C, Ferragud A, Moore CF, Everitt BJ, Sabino V, Cottone P. High trait impulsivity predicts food addiction-like behavior in the rat. Neuropsychopharmacology. 2014;39:2463-72.
• Atmaca M, Tezcan E, Parmaksiz S, Saribas M, Ozler S, Ustundag B. Serum ghrelin and cholesterol values in suicide attempters. Neuropsychobiology. 2006;54:59-63.
• Anderberg RH, Hansson C, Fenander M, Richard JE, Dickson SL, Nissbrandt H et al. The Stomach-Derived Hormone Ghrelin Increases Impulsive Behavior. Neuropsychopharmacol. 2016;41:1199-209.
• Muldoon MF, Manuck SB, Matthews KA. Lowering cholesterol concentrations and mortality: a quantitative review of primary prevention trials. BMJ. 1990;301:309-14.
• New AS, Sevin EM, Mitropoulou V, Reynolds D, Novotny SL, Callahan A et al. Serum cholesterol and impulsivity in personality disorders. Psychiatry Res. 1999;85:145-50.
• Marcinko D, Bilic V, Pivac N, Tentor B, Franic T, Loncar M et al. Serum cholesterol concentration and structured individual psychoanalytic psychotherapy in suicidal and non-suicidal male patients suffering from borderline personality disorder. Coll Antropol. 2011;35 Suppl 1:219-23.
• Atmaca M, Kuloglu M, Tezcan E, Ustundag B, Gecici O, Firidin B. Serum leptin and cholesterol values in suicide attempters. Neuropsychobiology. 2002;45:124-7.
• Umhau JC, George DT, Heaney RP, Lewis MD, Ursano RJ, Heilig M et al. Low vitamin D status and suicide: a case-control study of active duty military service members. PLoS One. 2013;8:e51543.
• Patrick RP, Ames BN. Vitamin D and the omega-3 fatty acids control serotonin synthesis and action, part 2: relevance for ADHD, bipolar disorder, schizophrenia, and impulsive behavior. FASEB J. 2015;29:2207-22.
• Riis P. Perspectives on the Fifth Revision of the Declaration of Helsinki. JAMA. 2000;284:3045-6.
• Beck AT, Epstein N, Brown G, Steer RA, 1988. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 56, 893-97.
• Ulusoy M. Turkish version of the Beck Anxiety Inventory: psychometric properties. J Cognit Psychother Internat Quart. 1998;12:2.
• Beck AT, Steer RA. Internal consistencies of the original and revised Beck Depression Inventory. J Clin Psychol. 1984;40,1365-67.
• Hisli, N. Beck Depresyon Envanterinin üniversite öğrencileri için geçerliği, güvenirliği. Psikoloji Dergisi. 1989;7, 3-13.
• Patton JH, Stanford MS, Barratt ES. Factor structure of the Barratt impulsiveness scale. J Clin Psychol. 1995;51:768-74.
• Tamam L, Güleç H, Karatas G. (2013). Barratt Dürtüsellik Ölçegi Kisa Formu (BIS-11-KF) Türkçe Uyarlama Çalismasi/Short Form of Barratt Impulsiveness Scale (BIS-11-SF) Turkish Adaptation Study. Noro-Psikyatri Arsivi. 50, 130.
• Buss AH, Perry M. The aggression questionnaire. J Pers Soc Psychol. 1992;63:452.
• Madran, HAD. Buss-Perrı saldırganlık Ölçeği’nin Türkçe formunun geçerlik ve güvenirlik çalışması. Türk Psikoloji Dergisi. 2012;24:1-6.
• Spitzer RL, First MB, Gibbon M, Williams JB. Structured clinical interview for DSM-III-R: American Psychiatric Press; 1990.
• Çorapçıoğlu A, Aydemir Ö, Yıldız M, Danacı A, Köroğlu E. DSM-IV Eksen I bozuklukları için yapılandırılmış klinik görüşmenin Türkçeye uyarlanması ve güvenilirlik çalışması. İlaç ve Tedavi Dergisi. 1999;12:33-6.
• Özkürkçügil A, Aydemir Ö, Yıldız M, Esen Danacı A, Köroğlu IV E. DSM-IV Eksen I bozuklukları için yapılandırılmış klinik görüşmenin Türkçe’ye uyarlanması ve güvenilirlik çalışması. İlaç ve Tedavi Dergisi. 1999;12:233-6.
• First MB, Spitzer RL, Gibbon M, Williams JB. The structured clinical interview for DSM-III-R personality disorders (SCID-II). Part I: Description. J Pers Disord. 1995; 9, 83-91.
• Coşkunol H, Bağdiken İ, Sorias S, Saygılı R. SCID-II Türkçe versiyonu görüşmesinin kişilik bozukluklarındaki güvenirliği. Türk Psikoloji Derg. 1994; 9: 26-9.
• Eagle DM, Lehmann O, Theobald DE, Pena Y, Zakaria R, Ghosh R et al. Serotonin depletion impairs waiting but not stop-signal reaction time in rats: implications for theories of the role of 5-HT in behavioral inhibition. Neuropsychopharmacology. 2009;34:1311-21.
• Eagle DM, Wong JC, Allan ME, Mar AC, Theobald DE, Robbins TW. Contrasting roles for dopamine D1 and D2 receptor subtypes in the dorsomedial striatum but not the nucleus accumbens core during behavioral inhibition in the stop-signal task in rats. J Neurosci. 2011;31:7349-56.
• Miyazaki KW, Miyazaki K, Tanaka KF, Yamanaka A, Takahashi A, Tabuchi S et al. Optogenetic activation of dorsal raphe serotonin neurons enhances patience for future rewards. Curr Biol. 2014;24:2033-40.
• Brown GL, Ebert MH, Goyer PF, Jimerson DC, Klein WJ, Bunney WE et al. Aggression, suicide, and serotonin: relationships to CSF amine metabolites. Am J Psychiatry. 1982;139:741-6.
• Hansson C, Alvarez-Crespo M, Taube M, Skibicka KP, Schmidt L, Karlsson-Lindahl L et al. Influence of ghrelin on the central serotonergic signaling system in mice. Neuropharmacology. 2014;79:498-505.
• Skibicka KP, Shirazi RH, Rabasa-Papio C, Alvarez-Crespo M, Neuber C, Vogel H et al. Divergent circuitry underlying food reward and intake effects of ghrelin: dopaminergic VTA-accumbens projection mediates ghrelin's effect on food reward but not food intake. Neuropharmacology. 2013;73:274-83.
• Atmaca M, Kuloglu M, Tezcan E, Gecici O, Ustundag B. Serum cholesterol and leptin levels in patients with borderline personality disorder. Neuropsychobiology. 2002;45:167-71.
• Stewart MA, Stewart SG. Serum cholesterol in antisocial personality. A failure to replicate earlier findings. Neuropsychobiology. 1981;7:9-11.
• Ralevski E, Shanabrough M, Newcomb J, Gandelman E, Hayden R, Horvath TL et al. Ghrelin is related to personality differences in reward sensitivity and impulsivity. Alcohol Alcohol. 2018;53:52-6.
• Menzies JR, Skibicka KP, Leng G, Dickson SL. Ghrelin, reward and motivation. Endocr Dev. 2013;25:101-11.
• Galanti K, Gluck ME, Geliebter A. Test meal intake in obese binge eaters in relation to impulsivity and compulsivity. Int J Eat Disord. 2007;40:727-32.
• Engel SG, Corneliussen SJ, Wonderlich SA, Crosby RD, le Grange D, Crow S et al. Impulsivity and compulsivity in bulimia nervosa. Int J Eat Disord. 2005;38:244-51.
• Fowkes FG, Leng GC, Donnan PT, Deary IJ, Riemersma RA, Housley E. Serum cholesterol, triglycerides, and aggression in the general population. Lancet. 1992;340:995-8.
• Mathew NT, Meyer JS, Achari AN, Dodson RF. Hyperlipidemic neuropathy and dementia. Eur Neurol. 1976;14:370-82.
• Silva H, Iturra P, Solari A, Villarroel J, Jerez S, Vielma W et al. Serotonin transporter polymorphism and fluoxetine effect on impulsiveness and aggression in borderline personality disorder. Actas Esp Psiquiatr. 2007;35:387-92.
• Steegmans PH, Fekkes D, Hoes AW, Bak AA, van der Does E, Grobbee DE. Low serum cholesterol concentration and serotonin metabolism in men. BMJ. 1996;312:221.
• Alvarez JC, Cremniter D, Lesieur P, Gregoire A, Gilton A, Macquin-Mavier I et al. Low blood cholesterol and low platelet serotonin levels in violent suicide attempters. Biol Psychiatry. 1999;45:1066-9.
• Korkmaz S, Ustundag B, Ozer O, Tasc G, Kaya S, Atescelik M et al. Copeptin levels and blood lipid profile in borderline patients with or without self-mutilation. S Afr J Psychiatry. 2016;22:976.
• Virkkunen M, De Jong J, Bartko J, Goodwin FK, Linnoila M. Relationship of psychobiological variables to recidivism in violent offenders and impulsive fire setters. A follow-up study. Arch Gen Psychiatry. 1989;46:600-3.
• Robbins TW, Crockett MJ. Role of central serotonin in impulsivity and compulsivity: comparative studies in experimental animals and humans. Handbook of Behavioral Neuroscience: Elsevier; 2010. p. 415-27.
• Greenberg BD, Li Q, Lucas FR, Hu S, Sirota LA, Benjamin J et al. Association between the serotonin transporter promoter polymorphism and personality traits in a primarily female population sample. Am J Med Genet. 2000;96:202-16.
• Kahn RS, van Praag HM, Wetzler S, Asnis GM, Barr G. Serotonin and anxiety revisited. Biological Psychiatry. 1988;23:189-208.
• Farmer R. Hostility and deliberate self-poisoning: the role of depression. Br J Psychiatry. 1987;150:609-14.
• Brown GL, Goodwin FK, Bunney WE, Jr. Human aggression and suicide: their relationship to neuropsychiatric diagnoses and serotonin metabolism. Adv Biochem Psychopharmacol. 1982;34:287-307.