April 1994

Familial Correlates of Reduced Central Serotonergic System Function in Patients With Personality Disorders

Author Affiliations

From the Clinical Neuroscience Research Unit, Department of Psychiatry, Medical College of pennsylvania, Philadelphia (Dr Coccaro); the Department of Psychiatry, Mt Sinai School of Medicine, New York, NY (Drs Silverman and siever); the Department of Psychiatry, St Lukes-Roosevelt Medical Center, New York, NY (Dr Klar); and the Northport Veterans Affairs medical Center, Northport, NY (Dr Horvath).

Arch Gen Psychiatry. 1994;51(4):318-324. doi:10.1001/archpsyc.1994.03950040062008

Background:  To test the hypothesis that evidence of reduced central serotonergic (5-HT) system function in probands with personality disorders is associated with an elevated morbid risk of psychopathological conditions putatively associated with 5-HT dysfunction in firstdegree relatives of these probands.Methods:Data were collected during a study of the 5-HT correlates of behavior in male patients with DSM-III personality disorders conducted at a Veterans Affairs medical center. Probands in this study were selected from those patients who had undergone both a fenfluramine hydrochloride challenge and a family history assessment. Axis II diagnoses were made acording to DSM-III criteria after a structured interview of the proband, using the Structured Interview for Diagnosing Personality Disorders, given by two raters and a similar interview with a knowledgeable informant by another rater.

Results:  Reduced prolactin responses to the 5-HT releasing/uptake inhibiting agent fenfluramine was associated with an elevated morbid risk of impulsive personality disorder traits in the first-degree relatives of patients with a primary DSM-III diagnosis of a personality disorder. Quantitative scores on assessments of impulsive aggression in the probands were not correlated with an increased morbid risk for impulsive personality disorder traits. A trend in the same direction was noted for affective personality disorder traits and alcoholism.

Conclusions:  These results suggest that a central 5-HT system abnormality in probands is associated with an increased risk of impulsive aggression in their first-degree relatives, and that assessment of central 5-HT system function in probands may be a more sensitive parameter for identification of this familial trait than the presence of impulsive aggressive behaviors in the proband.