Mitochondrial respiratory activity and DNA damage in peripheral blood mononuclear cells in borderline personality disorder

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: r _x = −0.36 and −0.35, p _adj ’s < .037). Decreased mitochondrial activity was closely associated with greater DNA damage (e.g., coupling efficiency: r _S = −0.57, p < .001), although DNA damage did not differ between diagnostic groups. Our findings suggest mitochondrial energy production processes as promising and sensitive biomarkers for acute disorder severity and clinical remission in BPD.