Relationship between 5-HT function and impulsivity and aggression in male offenders with personality disorders

Background Reduced serotonergic (5-HT)function and elevated testosterone have been reported in aggressive populations. Aims To investigate relationships between impulsivity, aggression. 5-HT function and testosterone in male offenders with personality disorders. Method Sixty male offenders with DSM-III-R personality disorders and 27 healthy staff controls were assessed using the Special Hospital Assessment of Personality and Socialisation (SHAPS), impulsivity and aggression ratings. d-fenfluramine challenge and plasma hormone concentrations. Results The SHAPS non-psychopaths and those with schizoid personality disorders had enhanced 5-HT function (prolactin response to d-fenfluramine). Reduced 5-HT function was found in offenders with DSM-III-R borderline personality disorders and those with a history of repeated self-harm or alcohol misuse. The 5-HT function was inversely correlated more strongly with impulsivity than with aggression. Plasma testosterone correlated positively with aggressive acts. The SHAPS primary psychopaths had lower initial cortisol and higher testosterone concentrations than controls. Conclusions Future studies are needed to investigate regional brain 5-HT function. Declaration of interest Funded by a Wellcome Trust Training Fellowship to M.D.