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2014 ; 39
(8
): 1799-804
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Enhanced emotional empathy after mineralocorticoid receptor stimulation in women
with borderline personality disorder and healthy women
#MMPMID24535100
Wingenfeld K
; Kuehl LK
; Janke K
; Hinkelmann K
; Dziobek I
; Fleischer J
; Otte C
; Roepke S
Neuropsychopharmacology
2014[Jul]; 39
(8
): 1799-804
PMID24535100
show ga
The mineralocorticoid receptor (MR) is highly expressed in the hippocampus and
prefrontal cortex. MR have an important role in appraisal processes and in
modulating stress-associated emotional reactions but it is not known whether the
MR affects empathy. Borderline personality disorder (BPD) is characterized by
disturbed emotion regulation and alterations in empathy. In the current study, we
examined whether stimulation of the MR enhances empathy in patients with BPD and
healthy individuals. In a placebo-controlled study, we randomized 38 women with
BPD and without psychotropic medication, and 35 healthy women to either placebo
or 0.4?mg fludrocortisone, an MR agonist. Subsequently, all participants
underwent two tests of social cognition, the Multifaceted Empathy Test (MET) and
the Movie for the Assessment of Social Cognition (MASC), measuring cognitive and
emotional facets of empathy. Eighteen BPD patients and 18 healthy women received
placebo, whereas 20 BPD patients and 17 healthy women received fludrocortisone.
In the MET, fludrocortisone enhanced emotional empathy across groups, whereas
cognitive empathy was not affected. In the MASC, no effect of fludrocortisone
could be revealed. In both tests, BPD patients and healthy women did not differ
significantly in cognitive and emotional empathy and in their response to
fludrocortisone. Stimulation of MR enhanced emotional empathy in healthy women
and in BPD patients. Whether fludrocortisone might have a therapeutic role in
psychotherapeutic processes, remains to be elucidated.