Alterations in the central and peripheral energy metabolism are increasingly recognized as key pathophysiological processes in various psychiatric disorders. This case-control study investigates mitochondrial energy production and oxidative DNA damage in Borderline Personality Disorder (BPD). We compared mitochondrial respiration, density, and DNA damage in peripheral blood mononuclear cells between women with acute BPD, remitted BPD, and healthy controls (n = 32, 15, 29), matched for age and BMI. Acute BPD was characterized by reduced and less efficient mitochondrial ATP production compared to both remitted BPD and controls (e.g., coupling efficiency: rx = -0.36 and -0.35, padj's < .037). Decreased mitochondrial activity was closely associated with greater DNA damage (e.g., coupling efficiency: rS = -0.57, p < .001), although DNA damage did not differ between diagnostic groups. Our findings suggest reduced mitochondrial energy production processes as promising and sensitive biomarkers for acute disorder severity and clinical remission in BPD.

The authors have declared no competing interest.

The study was funded by institutional resources from I.-T. Kolassa. Clinical data and blood samples were obtained from the Clinical Research Unit 256 (Christian Schmahl, Grant No. SCHM 1526/13-1), which is funded by the German Research Foundation (Deutsche Forschungsgemeinschaft, DFG).

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethics committees of Ulm University and Heidelberg University gave ethical approval for this work.

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All data produced in the present study are available upon reasonable request to the authors