Opioid addiction and borderline personality disorder

Chronic Pain and Psychiatric Conditions

Introduction

Chronic pain is a common condition with high socioeconomic and public health burden. A wide range of psychiatric conditions are often comorbid with chronic pain and chronic pain conditions, negatively impacting successful treatment of either condition. The psychiatric condition receiving most attention in the past with regard to chronic pain comorbidity has been major depressive disorder, despite the fact that many other psychiatric conditions also demonstrate epidemiological and genetic overlap with chronic pain. Further understanding potential mechanisms involved in psychiatric and chronic pain comorbidity could lead to new treatment strategies both for each type of disorder in isolation and in scenarios of comorbidity.

Methods

This article provides an overview of relationships between DSM-5 psychiatric diagnoses and chronic pain, with particular focus on PTSD, ADHD, and BPD, disorders which are less commonly studied in conjunction with chronic pain. We also discuss potential mechanisms that may drive comorbidity, and present new findings on the genetic overlap of chronic pain and ADHD, and chronic pain and BPD using linkage disequilibrium score regression analyses.

Results

Almost all psychiatric conditions listed in the DSM-5 are associated with increased rates of chronic pain. ADHD and BPD are significantly genetically correlated with chronic pain. Psychiatric conditions aside from major depression are often under-researched with respect to their relationship with chronic pain.

Conclusion

Further understanding relationships between psychiatric conditions other than major depression (such as ADHD, BPD, and PTSD as exemplified here) and chronic pain can positively impact understanding of these disorders, and treatment of both psychiatric conditions and chronic pain.

Borderline personality disorder symptoms and exposure to violence as risk factors for opioid use in adulthood

Borderline personality disorder and exposure to violence are both risk factors for opioid use. While past research has identified these relationships, there has yet to be any study which investigates the potential that exposure to violence may help explain the relationship between borderline personality disorder symptoms and opioid use as a mediator. The present study used data from the Pathways to Desistance study to test these proposed relationships. Results indicated that greater levels of borderline personality disorder symptoms were associated with increased opioid use frequency. However, when exposure to violence variables were included in the model, the magnitude of this effect was attenuated by more than 20% and reduced to non-significance. These results indicate the importance of identifying and treating borderline personality disorder symptomatology and to provide increased oversight of the environments which juvenile offenders are exposed to upon reentry. Doing so may help to address the opioid crisis in the United States.