Oxytocin, cortisol, and testosterone are involved in the processing of reward and stress and greatly influence mother-child interactions. Altered hormonal systems have been associated with borderline ...personality disorder (BPD), a disorder characterized by interpersonal deficits. Mothers with BPD tend to perceive interactions with the child as less rewarding and more stressful and interactions are often less reciprocal and have more negative states (i.e. constricted, tense, uncoordinated behaviors). Their children are at elevated risk for psychopathologies. Here, we studied underlying hormonal mechanisms of disrupted mother-child interaction in BPD.
Twenty-five mothers with BPD and 29 healthy mothers with their 18- to 36-month-old toddlers participated in a free-play mother-child interaction, which was evaluated with the Coding Interactive Behavior (CIB) Manual. Maternal blood samples were analyzed at baseline for oxytocin, cortisol, and testosterone, and after interaction for oxytocin and cortisol.
Oxytocin decreased and cortisol remained unchanged in mothers with BPD while healthy mothers showed stable oxytocin and decreased cortisol after interaction. Testosterone basal levels were significantly higher in mothers with BPD. Cortisol reactivity and testosterone levels mediated the association between maternal BPD and dyadic negative states during interaction.
These findings suggest that alterations in oxytocin, cortisol, and testosterone contribute to disruptions in mother-child interaction in BPD. Interacting with their child might not result in reward and relief of stress in mothers with BPD in the same way as in healthy mothers. Further research is needed to understand more about dyadic bio-behavioral processes in order to provide targeted parenting support. This could break the cycle of transgenerational transmission and improve maternal and child well-being.
•Mother-child interaction can be disturbed in borderline personality disorder (BPD).•Oxytocin decreased after mother-child interaction in mothers with BPD.•Cortisol remained unchanged after mother-child interaction in mothers with BPD.•Cortisol and testosterone mediated dyadic negative states during interaction.•Interaction might not result in reward and relief of stress in mothers with BPD.
To determine a levothyroxine (T4) dose recommendation for the treatment of autoimmune thyroiditis (AIT)-induced hypothyroidism.
T4 doses in 75 children and adolescents with newly diagnosed AIT were ...prospectively collected and compared to T4 doses of patients with congenital hypothyroidism (CH, n=22).
Sixty-four patients with AIT and 22 patients with CH were included in the analysis. The thyroid-stimulating hormone declined significantly from 25.8±50.1 to 2.1±1.5 μIU/mL (AIT group; p<0.01) and from 338.7±380.7 to 1.9±1.6 μIU/mL (CH group; p<0.01). The required T4 dose for patients with AIT was 1.5±0.5 μg/kg per day (≥6 to <10 years: 2.0±0.4 μg T4/kg per day; ≥10 to <12 years: 1.6±0.4 μg T4/kg per day; ≥12 to <14 years: 1.5±0.6 μg T4/kg per day; ≥14 years: 1.4±0.6 μg T4/kg per day). It deviated significantly from the CH patients’ mean T4 dose of 2.8±0.7 μg T4/kg per day, p<0.01. CH patients with athyreosis required an average dose of 3.1±0.5 μg T4/kg per day; patients with ectopia, 2.6±0.7 μg T4/kg per day; and patients with dyshormonogenesis, 2.5±0.6 μg T4/kg per day.
Juvenile patients with AIT require significantly lower T4 doses than patients with CH.
Congenital hyperinsulinism (CHI) is a rare disease with an estimated incidence of 1:40,000 live births. Here, we characterize 11 patients treated at Munich Children's Hospital Schwabing.
We analyzed ...data on birth, treatment and laboratory results including genetic testing and evaluated the long-term course with a follow-up visit.
All patients had severe, diazoxide-(DZX)-resistant hypoglycemia, beginning immediately after birth. Two patients were treated by medical therapy, eight underwent subtotal pancreatectomy and one had a partial resection. Both patients who had medical therapy still suffer from occasional hypoglycemia. Six patients with subtotal pancreatectomy were affected by mild hypoglycemia. Seventy-five percent of patients who had surgical treatment developed diabetes mellitus (DM) at a median age of 10.5 (8-13) years. In 89% of patients with available genetic testing, mutations of the ABCC8 gene were detected.
The majority of CHI-patients not responding to DZX underwent surgery. After subtotal pancreatectomy, patients typically developed diabetes around early puberty.
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