Borderline Personality Disorder Could Be a Syndrome of Emotional Dysregulation

The debate continues about whether borderline personality disorder (BPD) is a distinct disorder or an aggregation of features seen in other conditions (NEJM JW Psychiatry Jul 2011 and Acta Psychiatr Scand 2011; 123:349). A meta-analysis has now provided additional insights.

There were 19 functional magnetic resonance imaging studies of 281 patients with BPD (defined by DSM-III or later) and 293 controls, plus 10 studies of gray matter volume (GMV) in 263 BPD patients and 278 controls. In unmedicated BPD patients versus controls, activation in response to negative versus neutral stimuli was distinctly increased in the left amygdala and left hippocampus (but not in patients treated with unstated medications), was increased in the posterior cin…