Deficits in social cognition and interpersonal difficulties are key features in borderline personality disorder. Social cognition refers to the function of perceiving and adequately dealing with social signals, leading to the establishment and maintenance of healthy and positive social relationships. Evidence suggests that oxytocin (OT) may improve social cognition and human social behavior. Recently, several studies have highlighted the beneficial effects of oxytocin in several psychiatric conditions involving social cognition deficits such as schizophrenia, autism or social phobia. However, despite growing interest, the effects of oxytocin in patients with borderline personality disorder are far from being clearly demonstrated.

The objective of this work was to review and discuss studies investigating the interest of oxytocin in alleviating social cognition deficits in patients with borderline personality disorder (recognition of emotion, trust and cooperation, affective and cognitive empathy, emotional expression and social problem-solving).

A systematic review of the literature was conducted up to September 31, 2016 on the Pubmed, Science direct, Medline and Scopus databases using “borderline personality disorder” and “oxytocin” as keywords. To be included, studies were to include patients with borderline personality disorder; to investigate social cognition and to investigate the effect of oxytocin on social cognition in patients with TPB.

The initial search yielded 52 articles. Among them, 11 studies were selected according to the PRISMA criteria. The effect of oxytocin on social cognition in patients with borderline personality disorder was mainly investigated in relation to recognition of emotions and trust and cooperation. We did not find any studies investigating the effect of oxytocin on affective and cognitive empathy, emotional expression or social problem-solving abilities. In patients with borderline personality disorder, oxytocin had a beneficial impact on recognition and discrimination of emotions and on hypervigilance towards social threats. However, oxytocin could hinder trust and cooperation.

These data lead us to consider oxytocin as a treatment for emotion recognition deficit and hypervigilance towards social threats in borderline personality disorder. A beneficial effect of oxytocin of this nature may be obtained only in patients without deficits in trust and cooperation because of a risk of aggravating relational instability. There was no current evidence for the interest of oxytocin in enhancing affective and cognitive empathy in borderline personality disorder. Further studies are needed to evaluate the clinical interest of combining oxytocin with psychotherapeutic approaches such as dialectical behavioral therapy or mentalisation-based treatment.

L’objectif de cette revue est d’évaluer l’intérêt de l’ocytocine sur les différentes dimensions de la cognition sociale qui sont altérées dans le trouble de la personnalité borderline : la reconnaissance des émotions, l’empathie affective, l’expression des émotions, l’empathie cognitive, la résolution des problèmes sociaux et la confiance et la coopération.

Revue systématique de la littérature des banques de données informatisées Pubmed, Science direct, Medline et Scopus avec les mots clés : « borderline personality disorder » et « oxytocin ».

Parmi les 52 études retrouvées dans la littérature, 11 études ont été retenues. Ces études montrent que l’ocytocine est efficace sur le déficit de reconnaissance des émotions et sur l’hypervigilance à la menace sociale chez les patients présentant un trouble de la personnalité borderline. Cependant, l’ocytocine peut également aggraver la difficulté à faire confiance et à coopérer avec un partenaire social. Nous n’avons pas retrouvé d’études sur l’expression des émotions, sur l’empathie affective et cognitive et sur la résolution des problèmes sociaux.

Ces données nous amènent à envisager l’utilisation d’ocytocine pour traiter le déficit dans la reconnaissance des émotions et l’hypervigilance à la menace sociale chez les patients avec un trouble de la personnalité borderline. Cependant, l’ocytocine ne devrait pas être administrée aux patients avec un déficit dans la confiance et la coopération au risque d’aggraver leur instabilité relationnelle.