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QTc dispersion and interval changes in drug-free borderline personality disorder adolescents

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Abstract

Emotional instability and dysregulation represent a core feature of borderline personality disorder (BPD) and abnormal patterns of sympathetic/parasympathetic activity have been repeatedly investigated in individuals with this disorder. Such abnormalities may represent the substrate for an arrhythmogenic risk that could materialize the following specific drug exposure. In this work, we decided to assess basal-corrected QT interval and dispersion (QTc and QTcd) for estimating such risk in a sample of drug-free adolescents with diagnosis of BPD. In this cross-sectional comparative study, we recruited n = 70 female adolescent BPD (14.7 ± 1.3 years), free of medications, alcohol or recreational drugs. Furthermore, n = 70 matched female healthy controls (CTRL, 14.6 ± 1.5 years) were enrolled. QTc and QTcd were manually assessed on a standard 12-lead ECG by a single experienced investigator who was unaware of clinical outcomes. QTcd was increased by 7 ms on average in BPD vs. CTRL (+ 18%, p = 0.03). QTc was decreased by about 15 ms on average in BPD vs. CTRL (p = 0.003). A mild correlation was found between QTc and QTcd in BPD (r = 0.25, p = 0.03) that was not present in CTRL. No correlation was found between either QTc or QTcd, and age in both groups. Mildly increased QTcd characterizes the cardiac activity regardless of drug exposure in female adolescents with BPD. This information may be of value to clinicians striving to use neuroleptic and antidepressant drugs with a lower risk of QTcd increase.

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Authors and Affiliations

  1. School of Medicine and Surgery and Milan Center for Neuroscience, University of Milano, Bicocca, Italy

    Monica Bomba, Anna Riva, Fabiola Corbetta, Elisa Conti, Lucio Tremolizzo & Renata Nacinovich

  2. Child and Adolescent Mental Health, “San Gerardo” Hospital, Via Pergolesi 33, 20900, Monza, MB, Italy

    Monica Bomba, Anna Riva, Fabiola Corbetta & Renata Nacinovich

  3. Geriatric Unit, Spedali Civili, Department of Medical and Surgery Sciences, University of Brescia, Brescia, Italy

    Franco Nicosia

  4. Department of Pediatrics, Foundation Monza and Brianza for the Mother and Her/His Child, Monza, Italy

    Francesca Lanfranconi

  5. Neurology Unit, “San Gerardo” Hospital, Monza, Italy

    Lucio Tremolizzo

Authors
  1. Monica Bomba
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  2. Franco Nicosia
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  3. Anna Riva
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  4. Fabiola Corbetta
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Correspondence to Monica Bomba.

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The present research has been approved by the local ethics committee and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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All subjects gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study were omitted.

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Bomba, M., Nicosia, F., Riva, A. et al. QTc dispersion and interval changes in drug-free borderline personality disorder adolescents. Eur Child Adolesc Psychiatry 29, 199–203 (2020). https://doi.org/10.1007/s00787-019-01343-3

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  • DOI: https://doi.org/10.1007/s00787-019-01343-3

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