缓解期双相情感性精神障碍患者认知功能

目的:了解缓解期双相情感性精神障碍患者认知功能损害的特点。方法:采用逻辑记忆、视觉再生记忆、连线测验A和B、数字广度测验、威斯康星卡片分类测验(WCST)及字色混淆测验(stroop)对62例缓解期双相情感性精神障碍患者(患者组)和62名健康者(对照组)进行有关言语学习和记忆、非言语学习和记忆、注意以及执行功能的神经心理学评定,比较两组间认知功能的差异。结果:患者组在即刻逻辑记忆、延迟逻辑记忆、连线测验A和B、WCST正确应答数、完成分类数、持续性错误数以及Stroop C-W操作分上均显著低于对照组(P<0.05~0.01)。结论:双相情感性精神障碍患者的认知缺陷有其特点。     

单相抑郁患者缓解期认知功能损害观察

目的探讨单相抑郁患者缓解期的认知功能状况。方法对58例单相抑郁患者在发作期和缓解期(试验组)及30名健康对照者(对照组)进行WCST、CPT、TMT和CWT,并对结果进行比较和分析。结果 WCST:试验组发作期的正确反应数及完成分类数少于缓解期,错误总数、持续错误数及随机错误数多于缓解期(P0.05);试验组发作期及缓解期的正确反应数及完成分类数少于对照组,总测验次数、错误总数、持续错误数及随机错误数多于对照组(P0.05)。CPT:试验组发作期的正确反应数1、2、3少于缓解期,错误次数1、2、3多于缓解期(P0.05);试验组发作期及缓解期的正确反应数1、2、3少于对照组,错误次数1、2、3及持续错误数多于对照组(P0.05)。TMT:试验组发作期的连线测验A、B用时长于缓解期(P0.05);试验组发作期及缓解期的连线测验A、B用时长于对照组(P0.05)。CWT:试验组发作期的色词测验A、B、C用时长于缓解期(P0.05);试验组发作期及缓解期的色词测验A、B、C用时长于对照组(P0.05)。结论缓解期患者的认知功能虽较发作期有所改善,但仍达不到健康人的水平。     

首发精神分裂症患者神经认知功能的遗传学分析

目的 探索精神分裂症患者及其亲属共同存在的神经认知功能损害,并对22号染色体上儿茶酚氧位甲基转移酶(COMT)基因和脯氨酸脱氢酶(PRODH)基因的5个候选单核苷酸多态性(SNP)位点进行相关的遗传学分析。方法 采用14个神经心理测验(共29项)对235例首发精神分裂症患者(患者组)、322名未患病亲属(亲属组)和133名正常对照(正常对照组)进行有关智力、注意、记忆、言语功能和执行功能等评定,比较各组间的神经认知功能有无差异,并对上述神经认知功能测验与COMT和PRODH基因的5个候选SNP进行定量性状的传递不平衡测试。结果 (1)患者组所有测验的成绩均差于正常对照组,差异有显著性(P<0.01和P<0.05),而亲属组的记忆、注意、言语功能和执行功能界于患者与正常对照之间;(2)PRODH1 195G/A与即刻逻辑记忆测验(P=0.03)、言语流畅性测验的正确数(P=0.03)和连线测验B的犯规数(P=0.01)相关,PRODH1945G/A与数字符号测验(P:0.01)、连线测验A的错误数(P:0.02)、HANOI塔测验的总分(P=0.01)、威斯康星卡片分类测验(WCST)的总错误数(P=0.01)、WCST的非持续错误数(P:0.02)和WCST的总分类数(P=0.02)相关。结论 精神分裂症患者在记忆、注意、言语功能和执行功能等方面存在广泛的神经认知功能损害,这种损害可能是精神分裂症的遗传“内表     

中重度晚发抑郁症患者的神经认知功能损害分析

目的探讨中重度晚发抑郁症患者神经认知功能损害的特征。方法选取2017年2月至2019年2月我院收治的中重度晚发抑郁症患者50例作为观察组,采用重复性成套神经心理状态测验(RBANS)、词语流畅性测验(VFT)、威斯康星卡片分类测验(WCST)对神经认知功能损害情况予以评定,与同期收治的对照组50名健康体检者进行比较。采用汉密顿抑郁量表(HAMD-17)评估观察组抑郁严重程度,并分析它与认知损害的关系。结果在RBANS测验中,观察组晚期抑郁症患者即刻记忆、延时记忆、视觉广度、注意力、言语能力各维度评分均低于对照组,差异具有统计学意义(P0.05);观察组VFT测验评分经评定低于对照组(P0.05);在WCST测验中,两组完成分类数、完成第一分类所需应答数评分无差异(P0.05),观察组错误应答数、持续性错误百分数、持续性错误数、持续性应答数评分均高于对照组,概念化水平应答百分数评分高于对照组,P0.05);Spearman相关分析发现RBANS测验中的即刻记忆、延时记忆、视觉广度、注意力、言语能力各维度均与HAMD-17评分具正相关(r=0.39,0.42,0.45,0.38,0.40,P0.05);VFT和WCST测验中的持续性应答因子与HAMD-17评分呈负相关(r=-0.43,-0.51,P0.05)。结论中重度晚发抑郁症患者容易出现神经认知功能损害,认知功能损害与抑郁程度密切相关。     

不同亚型(阳性、阴性)精神分裂症患者精神症状与神经认知功能状况分析

目的探究不同亚型精神分裂症精神症状与神经认知功能差异及相互关系。方法将我院精神分裂症患者59例按PANSS分为阳性组和阴性组,采用PANSS评定患者精神症状,顶叶认知功能采用木块图测验和Benton线方向判断测验,额叶认知功能采用连线测验和威斯康星卡片分类测验,颞叶认知功能采用逻辑记忆测验和视觉再生测验。结果在各项认知功能测定上,阳性组和阴性组均不同程度与对照组存在差异(P0.05),阳性组与阴性组在木块图测验、逻辑记忆测验、视觉再生测验、连线测验及威斯康星卡片分类测验均存在显著差异(P0.01);阳性精神症状与逻辑记忆测验、视觉再生测验、完成分类数存在显著正相关(P0.01),阴性精神症状与连线B时间、思维灵活性、持续性错误存在显著正相关(P0.01),与木块图测验,逻辑记忆测验、视觉再生测验、完成分类数存在显著负相关(P0.01)。结论不同亚型精神症状与神经认知功能存在差异,顶叶及额叶认知功能与阴性症状关系密切,颞叶认知功能与阴性、阳性症状关系密切。     

联合应用尤瑞克林治疗缺血性脑卒中对患者执行功能的影响

目的观察尤瑞克林治疗对缺血性脑卒中患者后期执行功能的影响。方法 98例缺血性脑卒中患者随机分为治疗组与对照组,根据卒中治疗指南,两组均给予常规基础治疗,治疗组在此基础上联合尤瑞克林治疗,分别于治疗21d及3m后对两组患者采用蒙特利尔认知评估量表(MoCA)、简明智能状态量表(MMSE)、威斯康星卡片分类测验(WCST)进行神经心理学测验,评估执行功能。结果在21d测试中,治疗组仅在WCST中持续性错误数少于对照组(P<0.05),完成分类数多于对照组(P<0.05),但在3m后,治疗组MoCA总分高于对照组(P<0.01),治疗组MMSE成绩显著高于对照组(P<0.05),治疗组错误应答数明显减少(P<0.05),持续性错误数也明显减少(P<0.01),完成分类数增多(P<0.01)。与21d测验成绩相比,3m后第2次测验,治疗组成绩所有下降均不明显(P>0.05),而对照组MoCA总分及MMSE成绩显著下降(P<0.05),WCST持续性错误次数明显增多(P<0.01),完成分类数明显减少(P<0.01)。结论联合尤瑞克林治疗缺血性脑卒中可有效阻止患者视空间能力、认知灵活性、工作记忆等多项执行功能减退,预防血管性认知功能障碍的发生。     

双相抑郁与单相抑郁患者认知功能损害的比较

目的:探讨双相抑郁与单相抑郁患者认知功能损害情况。方法:对61例双相抑郁患者(双相组)及59例单相抑郁发作患者(单相组)及20名健康对照者(对照组)进行威斯康星卡片分类测验(WCST)、持续操作测验(CPT)、连线测验(TMT)和Stroop色词测验(CWT),并对结果进行比较和分析。结果:WCST:双相组的错误总数、持续错误数、随机错误数明显多于单相组和对照组,完成分类数明显少于单相组和对照组(P均0.01);双相组和单相组的正确反应数明显少于对照组(P均0.01);单相组的错误总数、持续错误数、随机错误数均多于对照组,完成分类数少于对照组(P均0.01)。CPT:双相组3个部分的正确反应数明显少于单相组和对照组,3个部分的错误次数明显多于单相组和对照组(P均0.01);单相组正确反应数Ⅰ少于对照组,错误次数Ⅱ多于对照组(P均0.01)。TMT:双相组TMT-A用时明显长于单相组和对照组(P均0.01)。CWT:双相组色词测验A、B、C用时明显长于单相组和对照组(P均0.01);单相组色词测验A、C用时明显长于对照组(P均0.01)。结论:双相抑郁及单相抑郁患者均有认知功能损害;双相抑郁患者执行功能、注意功能、记忆功能和信息处理速度等认知功能损害程度更重。     

抑郁症首次发病患者缓解期认知功能的研究

目的:探讨抑郁症首次发病患者缓解期认知功能情况。方法:对病程≤1年、完全缓解≥3个月的抑郁症患者(抑郁症组,31例)进行注意、记忆及执行功能测验,结果与性别、年龄、受教育程度相匹配的健康对照者(正常对照组,31人)比较。结果:注意测验:与正常对照组比较,抑郁症组持续性操作测验第二、第三情境错误数明显增多(P均0.01);Stroop-色词阅读中的完成数目、正确数明显减少(P均0.01),错误数增多(P0.05);连线测验A、B式完成时间明显延长(P0.05或P0.01)。记忆测验:抑郁症组理解记忆分测验总分及甲、乙项、视觉再生测验b、c项成绩较正常对照组差(P0.05或P0.01)。执行功能测验:抑郁症组威斯康星卡片分类测试的正确数、分类数及言语流畅性测验中正确数少于正常对照组(P0.05或P0.01)。结论:首次发病的抑郁症患者病情缓解≥3个月时仍有认知功能缺损。     

儿童少年期精神分裂症患者及其一级亲属认知功能的对照研究

目的:探讨儿童少年期精神分裂症患者及其一级亲属的认知功能状况. 方法:对40例儿童少年期精神分裂症患者(患者组)、80名父母(患者父母组)及22名同胞(患者同胞组)采用注意力测验、WMS-R-逻辑记忆、数字广度、连线测验A和B、词汇流畅性测验、Stroop色词测验及威斯康星卡片分类测验(WCST)评定其认知功能,并与59名健康儿童(健康儿童对照组)及其父母(健康儿童父母组)80名进行比较. 结果:患者组除词汇流畅性测验以外,其他测验成绩差于健康儿童对照组;患者同胞组除数字顺背、词汇流畅性测验、连线测验-A、WCST正确应答数、WCST完成第1个分类应答数以外,其他测验成绩差于健康儿童对照组(P均＜0.001);患者父母组除数字顺背、词汇流畅性测验、连线测验-A以外,其他测验成绩差于健康儿童父母组(P＜0.01或P＜0.001).儿童精神分裂症患者与其父母在注意力测验、WMS-R-逻辑记忆、数字倒背、彩色文字阅读和彩色文字颜色阅读、WCST完成分数上呈正相关(r =0.350～0.615,P＜0.05或P＜0.001). 结论:儿童少年期精神分裂症患者及其一级亲属均存在广泛的认知功能缺陷,但患者的认知功能障碍更为严重.     

社交焦虑障碍与认知功能的相关性研究

目的:探讨社交焦虑障碍(SAD)患者的社交障碍与认知功能的关系。方法:对60例SAD患者(SAD组)及60名性别、教育程度和年龄匹配的健康对照者(正常对照组)进行成套神经认知功能[包括威斯康辛卡片分类测验(WCST)、持续操作功能测试(CPT)、踪迹描绘测验(TMT)、词语流畅性测验(WFT)和听觉词语学习测验(AVLT)]评估及比较;并对患者进行利博维茨社交焦虑量表(LSAS)、状态-特质焦虑量表(STAI)及贝克抑郁量表第2版(BDI-II)临床评估;采用皮尔逊相关性对SAD患者临床状况评分与神经心理测试指标进行相关性分析。结果:SAD组WCST测试的完成分类数的测试分(5.2±1.4)明显低于正常对照组(5.3±0.6),持续性错误数(1.6±2.7)明显高于正常对照组(0.7±0.7)(P均0.05); LSAS评分(63.5±25.5)明显高于正常值(28.4±21.5);SAD组LSAS评分与WCST的持续性错误数呈正相关(r=0.535,P0.05),与WCST分类成绩呈负相关(r=-0.353,P0.05)。结论:SAD患者认知功能中的执行能力明显降低,并与SAD严重程度相关。     

Neuropsychological task performance in bipolar spectrum illness: genetics, alcohol abuse, medication and childhood trauma

Introduction:  Impaired executive and memory function is a putative genetic trait marker of bipolar I disorder (BPD I). Although executive/memory function has been posited to be an endophenotype of BPD I, it is unclear whether this extends to bipolar spectrum illness. It is also unclear to what extent non-genetic factors such as childhood abuse, alcoholism and medication influence neurocognitive function. We assessed the neuropsychological performance of a large cohort of bipolar disorder probands and their affectively ill and healthy family members, while controlling for self-reported childhood sexual and emotional abuse, emotional neglect, alcohol abuse and medication.
Methods:  A total of 230 largely euthymic participants from 47 families, comprising 49 subjects with BPD I, 19 with bipolar II disorder (BPD II), 44 with recurrent major depression (MDE-R), 33 with a single lifetime episode of depression (MDE-S), 20 with other DSM-IV diagnoses and 65 unaffected relatives, were assessed with a battery of neuropsychological tasks.
Results:  Sexual abuse, emotional abuse and emotional neglect scores were associated with poorer cognitive performance. After controlling for childhood trauma, the BPD I group performed worse than unaffected relatives on tests of visual recall memory as well as verbal recall and recognition memory. In contrast, individuals with BPD II and bipolar spectrum illness did not differ significantly from unaffected relatives. Treatment with lithium and antipsychotic medication was associated with reduced executive and verbal recognition memory function. After controlling for medication and other covariates, only verbal recall memory was significantly impaired in the BPD I cohort.
Conclusions:  Verbal recall deficits may be one manifestation of a genetically driven dysfunction of frontal-striatal cortical networks in BPD I.     

Cognitive function across manic or hypomanic, depressed, and euthymic states in bipolar disorder

OBJECTIVE: The study aims were to address neuropsychological functioning across different states of bipolar illness and to determine relationships among clinical features, neuropsychological performance, and psychosocial functioning. METHOD: Several domains of cognitive function were examined in 30 depressed bipolar patients (DSM-IV criteria for major depression, Hamilton Depression Rating Scale score > or = 17), 34 manic or hypomanic bipolar patients (DSM-IV criteria for manic or hypomanic episode, Young Mania Rating Scale score > or = 12), and 44 euthymic bipolar patients (6 months of remission, Hamilton depression scale score < or = 8, and Young Mania Rating Scale score < or = 6). The comparison group consisted of 30 healthy subjects without history of neurological or psychiatric disorders. A neuropsychological battery assessed executive function, attention, and verbal and visual memory. RESULTS: The three groups showed cognitive dysfunction in verbal memory and frontal executive tasks in relation to the comparison group. Low neuropsychological performance was associated with poor functional outcome. Impairment of verbal memory was related to the duration of illness and the numbers of previous manic episodes, hospitalizations, and suicide attempts. CONCLUSIONS: A poorer performance was observed in all bipolar groups regarding executive function and verbal memory in relation to the healthy comparison subjects. These cognitive difficulties, especially related to verbal memory, may help explain the impairment regarding daily functioning, even during remission. Further studies should focus on testing, whether optimizing prophylactic pharmacological treatment and psychoeducation might reduce cognitive impairment, and whether bipolar patients would benefit from neuropsychological rehabilitation in order to reduce the impact of cognitive impairment in their overall functioning.     

The cumulative load of depressive illness is associated with cognitive function in the remitted state of unipolar depressive disorder

ObjectiveTo investigate whether the cumulative number, duration and subtypes (severity and presence of psychotic features) of previous episodes of depression in patients with unipolar depressive disorder in a remitted state are associated with decreased global cognitive function.MethodsVia the Danish registers individuals between 40 and 80 years of age were identified: (1) patients with a diagnosis of unipolar disorder at their first discharge from a psychiatric hospital in the period 1994 to 2002, and (2) gender and age matched control individuals. The participants were assessed with the Cambridge Cognitive Examination (CAMCOG), which provides a composite measure of global cognitive function.ResultsA total of 88 patients and 50 controls accepted our invitation to participate, fulfilled the selection criteria and were included in the study. The cumulative duration of depressive episodes was associated with a decreased CAMCOG score adjusted for age, gender, education, premorbid IQ and residual depressive symptoms (B = ?0.14, 95% C.I. (?0.26, ?0.02), R²_adj = 0.31, P = .02). Significant associations were also found between CAMCOG score and the cumulative duration and total number of depressive episodes with psychotic features, respectively.ConclusionOur findings suggest that cognitive dysfunction is associated with the cumulative duration of depressive episodes, and that, in particular, depressive episodes with psychotic features in the course of illness may be a significant predictor of future impairment of cognitive function.     

Relationships Among History of Psychosis,Cognition and Functioning in Later-Life Remitted Major Depression

ObjectiveThis study tested the hypotheses that, in older adults with remitted major depression, a history of psychotic features and poorer neuropsychological performance would be independently associated with poorer everyday functioning, but that neuropsychological performance would explain more of the variance in functioning than history of psychotic features.MethodsThis cross-sectional study included 73 patients aged 50 years or older with remitted psychotic major depression or nonpsychotic major depression. The dependent variables were subjective and objective measures of function. The independent variables were history of psychotic features during one or more major depressive episodes in the previous 10 years and neuropsychological performance. Linear regression models examined the association of independent variables with function, controlling for pertinent covariates. Effect sizes were calculated for the magnitude of difference in function between the patient participants and an age- and gender-matched nonpsychiatric group, and distribution of functioning scores were compared between groups.ResultsIn separate models, history of psychotic features and poorer processing speed, executive function, and verbal learning were independently associated with poorer participant-reported functioning and performance-based functioning. However, the association of psychotic features with functioning was no longer statistically significant when tested in the same models as neuropsychological measures. Effect sizes of the difference in functioning between patients and the nonpsychiatric group were significantly larger for the remitted psychotic than the remitted nonpsychotic depression group; functioning scores were more heterogeneous in the remitted psychotic depression group.ConclusionPatients with remitted psychotic depression exhibit greater, and clinically important, impairment in everyday functioning than those with remitted nonpsychotic depression. Neuropsychological impairment appears to contribute to this relationship.     

Treatment emergent affective switch: a controlled study

OBJECTIVE: To study the clinical features of treatment emergent affective switch (TEAS) in comparison with spontaneous mania. METHODS: Twelve patients with TEAS within a 12-week period (average) of starting standard antidepressant medication were compared with 12 patients with spontaneous mania. RESULTS: Patients with TEAS were older, had longer duration of illness, more previous episodes, higher prevalence of subclinical hypothyroidism, and reported more previous episodes of mania associated with antidepressant use. TEAS was less severe, with a lower incidence of psychotic symptoms, lower Young Mania Rating Scale index score and rarely required hospitalization. The interval from intervention to response and remission was similar in both groups. CONCLUSION: TEAS was less severe, but had similar duration when compared with spontaneous mania. These results cannot directly answer the question of whether there is a causal relationship between antidepressant use and TEAS. While it is also possible that patients with longer duration of illness and higher cycle frequencies are more likely to experience episodes, it is difficult to attribute lesser severity of TEAS episodes to these clinical factors. Our observations are consistent with the suggestion that patients with longer duration of illness and previous history of TEAS may be at a greater risk of switching to mania during the use of antidepressants.     

Neuropsychological frontal lobe tests indicate that bipolar depressed patients are more impaired than unipolar

Objectives: The aim of this study was to compare the neuropsychological performance of patients with bipolar or unipolar mood disorders during acute episodes of depression using intelligence and frontal lobe tests. Methods: Fifteen patients with bipolar depression (BP) and 30 with unipolar depression (UP) were studied. For the neuropsychological assessment, the following tests: the Wechsler Adult Intelligence Scale-Revised (WAIS-R), the Trail Making Test (TMT), the Stroop test, the verbal fluency test and the Wisconsin Card Sorting Test (WCST) were used. Results: The mean intensity of depression and mean duration of illness were similar in both groups. Patients in the BP group achieved significantly lower levels of performance in the non-verbal part of WAIS-R, in both parts of the Stroop test, in the verbal fluency test and also showed a tendency to achieve poorer results in TMT-B than those in the UP group. Bipolar depressed patients also produced significantly poorer results with the WCST as they made twice as many perseverative errors and only completed half of the correct categories compared with the UP patients. The results of the TMT-A tests, which measure psychomotor slowness, were similar in BP and UP patients. No differences between the results of male and female patients were noted in either group. Deterioration of the results associated with duration of the illness was only observed in the UP patients. Conclusions: A higher degree of cognitive dysfunction connected with frontal lobe activity during an acute depressive episode was found in bipolar compared with unipolar depressed patients. These results may corroborate other findings pointing to pathogenic distinctions between bipolar and unipolar affective illness and to some similarities between bipolar illness and schizophrenia.     

The role of life events in onset and recurrent episodes of schizophrenia and schizoaffective disorder

The experience of both positive and negative recent life events has long been recognized as a possible precipitant of episodes of psychiatric illness. Among individuals with recurrent mood disorders, investigators have found that recent life events are more likely to be associated with initial and early episodes of illness, with later episodes less likely to be temporally associated with life events. This study investigated the relationship between recent life events and episodes of illness in schizophrenia (defined as the number of acute episodes of schizophrenia requiring hospitalization). Among 32 male U.S. Military veteran inpatients, those with three or fewer episodes of illness reported significantly more recent life events than those patients with more than three episodes of illness (P = 0.01). Overall, recent life events were negatively correlated with number of episodes (P < 0.05). These data suggest that initial or early episodes of schizophrenic illness are more likely to be associated with recent life events than are later episodes.     

The neuropsychological correlates of borderline personality disorder and suicidal behaviour.

OBJECTIVE: In subjects with borderline personality disorder (BPD), compared with subjects who attempted suicide, to review neuropsychological (NP) function that may predispose to suicidal behaviour along a continuum of high and low lethality. METHOD: We undertook electronic searches of MEDLINE, PsycINFO, EMBASE, Biosos Reviews, and Cinhal. The searches were restricted to English-language publications from 1985 onward. The search terms borderline personality disorder, suicide, suicide attempt, self-harm behaviour, neuropsychological, executive function (EF), neurocognitive, and neuropsychological function produced 29 neuropsychology studies involving BPD and 7 neuropsychology studies of suicide attempters, regardless of psychiatric diagnosis. RESULTS: Of the BPD studies, 83% found NP impairment in one or more cognitive domains, irrespective of depression, involving specific or generalized deficits linked to the dorsolateral prefrontal and orbitofrontal regions. The functions most frequently reported (in 71% to 86% of BPD studies) are response-inhibitory processes affecting executive function performance that requires speeded attention and visuomotor skills. Decision making and visual memory impairment are also most frequently affected; 60% to 67% of BPD studies report attentional impairment, verbal memory impairment, and visuospatial organizational impairment. Least affected processes in BPD appear to involve spatial working memory, planning, and possibly, IQ. The similarities in NP deficits found in BPD and suicide-attempt studies involve decision making and Trails performances. BPD studies, however, reflect more frequent impairment on the Stroop Test and Wisconsin Card Sort Test performance than the suicide-attempt studies, whereas verbal fluency appears to be more frequently impaired in those attempting suicide. CONCLUSIONS: Impaired EF and disinhibitory processes, as indicated by verbal fluency, Trails, and Stroop performance, primarily associated with dorsolateral prefrontal cortical regions may represent a dominant executive pathway to suicide attempt. A primary motivational inhibitory pathway involving conflictual, affective, and reflexive decision-making processes associated with orbitofrontal brain regions, in combination with significant cognitive rigidity, may influence the repetitive expression of self-harm or low-lethality suicidal behaviour. The hypothesis of a specific trait-like cognitive vulnerability for suicidal behaviour involving dysregulatory, disinhibiting pathways awaits confirmation.     

Magnetic resonance imaging volumes of the hippocampus and the amygdala in women with borderline personality disorder and early traumatization

BACKGROUND: Based on findings of stress-induced neural disturbances in animals and smaller hippocampal volumes in humans with posttraumatic stress disorder), we hypothesized that patients with borderline personality disorders (BPD), who often are victims of early traumatization, have smaller volumes of the hippocampus and the amygdala. We assumed that volumes of these brain regions are negatively correlated with traumatic experiences and with neuropsychological deficits. METHODS: We studied 21 female patients with BPD and a similar group of healthy controls. We performed clinical assessments, a modified version of the Childhood Trauma Questionnaire, and magnetic resonance imaging volumetric measurements of the hippocampus, amygdala, temporal lobes, and prosencephalon. Neuropsychological testing included scales on which disturbances in BPD were previously reported. RESULTS: The patients with BPD had nearly 16% smaller volumes of the hippocampus (P<.001) and 8% smaller volumes of the amygdala (P<.05) than the healthy controls. The results for both hemispheres were nearly identical and were controlled for the volume of the prosencephalon and for head tilts. The volumes of the hippocampus were negatively correlated with the extent and the duration of self-reported early traumatization only when BPD and control subjects were considered together. Levels of neuropsychological functioning were associated with the severity of depression but not with the volumes of the hippocampus. CONCLUSION: In female patients with BPD, we found reduction of the volumes of the hippocampus (and perhaps of the amygdala), but the association of volume reduction and traumatic experiences remains unclear. Arch Gen Psychiatry. 2000;57:1115-1122.