Increased IL-1ß reactivity upon a glucose challenge in patients with deliberate self-harm.

OBJECTIVE: A disturbed glucose metabolism has been observed in patients with aggressive behaviour. Interleukin (IL)-1ß is a pro-inflammatory cytokine that can induce hypoglycaemia, but has also been suggested to be involved in the generation of hostility and aggression. Our group has previously shown an altered glucose metabolism in patients with self-inflicted aggressive behaviour. We investigated the hypothesis that the levels of IL-1ß would be increased in these patients, because this might explain the aberrant glucose metabolism and add further knowledge to the aetiology of self-inflicted aggressive behaviour. METHOD: We investigated plasma cytokine changes in 13 patients with borderline personality disorder and 13 healthy controls during a 5-h glucose challenge. Plasma samples were analysed for cytokines IL-1ß, TNF-α and IL-6 using high-sensitivity multiplex ELISA. Psychiatric symptoms were rated using the Aggression Questionnaire Revised Swedish Version. RESULTS: Basal plasma levels of the three cytokines did not differ between patients and controls. All three cytokines reacted significantly upon the glucose challenge. The increase in IL-1ß levels in response to glucose was significantly greater in patients than in controls. Furthermore, IL-1ß reactivity was associated with symptoms of hostility. CONCLUSION: An increased reactivity of IL-1ß might be part of a pathogenetic mechanism in patients with deliberate self-harm.

Executive functioning in psychiatric patients with deliberate self-harm, as compared with a psychiatric and a healthy comparison group.

Introduction: Deliberate self-harm (DSH) is a common symptom in psychiatric disorders. It is a cross-diagnostic symptom, although it has mainly been associated with borderline personality disorder (BPD). Research has suggested an association between DSH and deficits in executive functioning. The main aim of the current study was to assess three specific aspects of executive functioning (EF) (working memory, inhibition and cognitive flexibility) among psychiatric patients with DSH, compared to a clinical and a healthy comparison group.Methods: Thirty psychiatric patients with DSH, 29 psychiatric patients without DSH and 29 healthy individuals were assessed with regard to psychiatric illness, self-harming behavior, EF, general cognitive functioning level and measures of psychopathology. The results were analyzed by means of ANOVA, regression analysis, Chi-square, and correlation analysis.Results: The patients with DSH showed deficits in cognitive flexibility and inhibition as compared to healthy individuals. In addition, the patients with DSH had greater deficits in cognitive flexibility than the patients without DSH; this effect was independent of concurrent severity of depressive symptoms but not independent of borderline symptomatology.Conclusion: Psychiatric patients with DSH may have deficits in cognitive flexibility as compared to both the healthy and clinical comparison groups. The results partly differ from previous related studies in the field. It is unclear to which extent the deficits in cognitive flexibility are due to other factors. More research is needed to understand the implications of such deficits, and if the results could be used for adapting treatment services and strategies. Future studies should include more similar comparison groups.