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The dexamethasone suppression test as a research variable

  • John F Greden

Abstract

In the late 1960s and early 1970s, a number of investigators began to utilize the dexamethasone suppression test (DST) as a neuroendocrine laboratory aid for identifying patients with endogenous depression (melancholia; vital depression) (Carroll, 1972; Carroll et al., 1976a, 1976b; Stokes, 1972). The rationale for this research strategy was that normal subjects have limbic-hypothalamic-pituitary-adrenal axis (L-H-P-A) suppression for more than 24 h after receiving a small oral dose of dexamethasone (1 or 2 mg). In contrast, approximately 40 to 70% of patients with melancholic pathophysiology have L-H-P-A non-suppression, reflected by plasma cortisol concentrations greater than 5 μg/d1 (using a competitive protein binding assay) or 4 μg/d1 (with most radioimmunoassays). Most early DST studies evaluated the diagnostic efficacy of the test (Carroll et al., 1981). Pilot studies also considered whether the test had value in objectively monitoring treatment progress, providing an early prediction of treatment outcome, selecting specific somatic treatments, indicating prognosis, aiding in diagnostic reclassification, or as a variable in pharmacological experiments (Greden et al., 1980, 1981a; Carroll et al., 1980a, 1980b; Goldberg et al., 1980).

Keywords

Anorexia Nervosa Borderline Personality Disorder Depressive Illness Complex Partial Seizure Dexamethasone Suppression Test 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© The contributors 1983

Authors and Affiliations

  • John F Greden
    • 1
  1. 1.Mental Health Research InstituteUniversity of Michigan Affiliated HospitalsAnn ArborUSA

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