The dexamethasone suppression test in depressed and non‐depressed geriatric medical inpatients

Abstract

The frequency of an abnormal response to the dexamethasone suppression test (DST) was examined in 38 geriatric patients hospitalized for medical illnesses and affected by depressive disorders diagnosed according to the DSM III, and in 18 medical patients (used as controls) hospitalized in the same ward. Only 11% of the controls and 11% of those affected by dysthymic disorder had an abnormal DST vs 73% of the patients with major depressive disorder (MDD). The sensitivity of the DST for MDD, in this particular setting, was found to be about 73% and the specificity 89%. The importance of this clinical adjunct in diagnosing the severe depressive disorders is discussed.

Assessment of Severity of Suicide Attempts

“…The level of sensitivity of the DST obtained in the group of suicide at tempters is only 28.57%, with a specificity of 70.37% and a predictive value of 20% (the 3 subjects without diagnosis were ex cluded from this evaluation). In the control sample, however, the results confirmed our previous findings [18,19] and those of other authors [13], with a sensitivity of 63.64%, a specificity of 94.44% and a predictive value of 93.3%.…”

The dexamethasone suppression test in dementia

“…Low noradrenalin concentrations have been found in numerous regions of the brain in patients with primary degenerative dementia, and depression itself is also associated with impaired noradrener-gic neurotransmission. A previous study by the present authors, [24] carded out in the same setting on patients with major depression, found a DST non-suppression rate of about 73%: since the non-suppression rate found in the present study was about 39%, it may be argued that DST testing is of limited value in differentiating between these two pathologies. Yet others [23] have stressed the relationship between serotoninergic neurotransmission and DST non-suppression in some forms of depression, and diminished serotonin levels have indeed been found in some patients with dementia.…”