Dexamethasone suppression test in a pluri‐diagnostic approach: its relationship to psychopathological and clinical variables

Abstract

Using a pluridiagnostic approach, the dexamethasone suppression test (DST) was studied in 67 depressed inpatients in its relationship to diverse clinical variables. The International Classification of Diseases (ICD), the Research Diagnostic Criteria (RDC), the Newcastle Index, the Hamilton Depression Rating scale (HAM-D), and the Bf-s self rating questionnaire were applied. Fifty-two per cent of endogenous depressed (ICD), 51% of major depressive (RDC) and 53% of endogenous depressed (Newcastle) patients demonstrated dexamethasone nonsuppression (DSTN) with a value above 110 nm/l. Six per cent of neurotic depressed (ICD), 9% of minor depressive (RDC) and 23% of neurotic depressed (Newcastle) patients were dexamethasone nonsuppressors. Significantly higher values (after P-correction) for DSTN could be detected in severity ratings as measured with Newcastle (P less than 0.001) and HAM-D global score (P less than 0.001) and also for HAM-D factor 4 (somatic complaints, P = 0.001). All the other evaluated variables did not discriminate between patients with dexamethasone suppression and with nonsuppression.

DST Studies in Psychotic Depression: A Meta-Analysis

“…No common factors were found. Miller and Nelson (51) reviewed 11 other studies (34,(56)(57)(58)(59)(60)(61)(62)(63)(64)(65) that examined the relationship of individual symptoms to DST results. The most common symptom correlates of the DST were psychomotor change (both retardation and agitation) and sleep disturbance, followed by weight loss and somatic anxiety.…”

Cortisol response to dexamethasone and noradrenergic function in depression

“…A proportion (35 to 60 per cent) of patients with major depression show a disturbed DST (1)(2)(3)(4)(8)(9)(10). Some authors have found that patients with major depression exhibit a disturbed MHPG excretion (11)(12).…”

Ventricular size, the dexamethasone suppression test and outcome of severe endogenous depression following psychosurgery

“…The percentage of patients failing to suppress their cortisol production has varied considerably (17,18). The DST does not appear to distinquish unipolar from bipolar depression but may be useful as a marker in unipolar depression with a genetic background (19), although other authors have failed to confirm this finding (20).…”