Summary
Endogenous depressive and schizophrenic patients demonstrated the same frequency of pathological DST results after admission. After 3 weeks of psychopharmacological treatment the percentage of abnormal DST results was significantly reduced in both groups, although the treatment conditions were different. A correlation between the DST non-suppression and intensity of depression was observed only in the depressive group, not in the schizophrenic group. Normalization of DST results in depressive patients was mostly associated with an improvement of depressive scores. Other course patterns of DST results did not seem to be combined with psychopathological changes. From this data it has to be concluded that DST non-suppression is in some part related to depressive symptoms, but is not characteristic or specific for endogenous depression or for depressivity.
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Amsterdam JD, Winokur A, Bryant S, Larkin J, Rickels K (1983) The dexamethasone suppression test as a predictor of antidepressant response. Psychopharmacology 80:43–50
Baumgartner A (1984) Serial dexamethasone suppression tests and TRH tests in depressed patients and controls. Collegium International Neuro-Psychopharmacologicum. 14. C.I.N.P.-Congress. Book of Abstracts, p 439
Beckmann H, Holzmüller B, Fleckenstein P (1984) Dexamethasone suppression test predicts response to nomifensine or amitriptyline. Br J Psychiatry 144:440–441
Berger M, Doerr P, Lund R, Bronisch T, von Zerssen D (1982a) Neuroendocrinological and neurophysiological studies in major depressive disorders: Are there biological markers for the endogenous subtype? Biol Psychiatry 17:1217–1242
Berger M, Klein HE (1984) Der Dexamethason-Suppressions-Test: Ein biologischer Marker der endogenen Depression? Eur Arch Psychiatr Neurol Sci 234:137–146
Berger M, Krieg JC, Pirke KM (1982b) Is the positive dexamethasone test in depressed patients a consequence of weight loss? Neuroendocrinol Lett 4:177
Berger M, Pirke KM, Doerr P, Krieg JC, von Zerssen D (1984) The limited utility of the dexamethasone suppression test for the diagnostic process in psychiatry. Br J Psychiatry 145:372–382
Bloodworth RC (1982) The use of the dexamethasone suppression test in the differential diagnosis of catatonic stupor. Int J Psychiatr Med 12:93–101
Brown WA, Johnston R, Mayfield D (1979) The 24-hour dexamethasone suppression test in a clinical setting: relationship to diagnosis, symptoms and response to treatment. Am J Psychiatry 136:543–547
Carman JS, Wyatt ES, Hall KR (1981) Dexamethasone suppression test: predictor of thymoleptic response in catatonic, paranoid, and schizoaffective patients. Neuroendocrinol Lett 3:122
Carroll BJ (1982) Clinical applications of the dexamethasone suppression test for endogenous depression. Pharmacopsychiatry 15:19–24
Carroll BJ, Feinberg M, Greden JF, Tarika J, Albala AA, Haskett RF, James N, Kronfol Z, Lohr N, Steiner M, de Vigne JP, Young E (1981) A specific laboratory test for the diagnosis of melancholia. Arch Gen Psychiatry 38:15–22
Coccora EF, Prudic J, Rothpearl A, Nurnberg HG, Davis KL (1983) The effect of hospitalization on the DST. Abstract 82. Annual Meeting of the Society of Biological Psychiatry, New York
Davis KL, Hollister LE, Mathe AA, Davis BM, Rothpearl AB, Faull KF, Hsieh JJK, Barchas JD, Berger PA (1981) Neuroendocrine and neurochemical measurements in depression. Am J Psychiatry 138:1555–1562
Dewan MJ, Pandurangi AK, Boucher MI, Levy BF, Major LF (1982) Abnormal dexamethasone suppression test results in chronic schizophrenic patients. Am J Psychiatry 139:1501–1503
Doerr P, Fichter M, Pirke KM, Lund R (1980) Relationship between weight gain and hypothalamic pituitary adrenal function in patients with anorexia nervosa. J Steroid Biochem 13:529–537
Fichter M, Pirke KM, Doerr P, Lund R (1981) Effect of behaviour therapy on weight gain, behaviour attitude and endocrine parameters in anorexia nervosa. In: Perris C, Struwe G, Jansson B (eds) Biological psychiatry. (Bio-Medical Press). Elsevier, Amsterdam, pp 1051–1054
Garver DL, Davis JM (1979) Biogenic amine hypothesis of affective disorders. Life Sci 24:383–394
Gold MS, Pottash ALC, Extein I (1980) Dexamethasone suppression tests in depression and response to treatment. Lancet I:1190
Goldberg IK (1980) Dexamethasone suppression test as indicator of safe withdrawal of antidepressant therapy. Lancet I:376
Graham PM, Booth J, Boranga G, Galheange S, Myers CM, Teoh CL, Cox IS (1981) The dexamethasone suppression test in mania. J Affective Disord 4:201–221
Greden JF, Kronfol Z, Gardner R, Feinberg M, Carroll B (1981) Neuroendocrine evaluation of schizoaffectives with the dexamethasone suppression test. In: Perris C, Struwe G, Jansson B (eds) Proc III World Congr of Biological Psychiatry. Elsevier/North Holland Biomedical Press, Amsterdam
Greden JF, Gardner R, Kind D, Grunhaus L, Carroll BJ, Kronfol Z (1983) Dexamethasone suppression tests in antidepressant treatment of melancholia. Arch Gen Psychiatry 40:493–500
Haskett RF, Athanasios PZ, Albala AA, Carroll BJ (1983) DST performance during first 48 hours of admission. Abstract 100: Annual Meeting of the Society of Biological Psychiatry, New York
Holsboer F, Liebl R, Hofschuster E (1982) Repeated dexamethasone suppression test during depressive illness. J Affective Disord 4:93–101
Kasper S, Beckmann H (1983) Dexamethasone suppression test in a pluridiagnostic approach: its relationship to psychopathological and clinical variables. Acta Psychiatr Scand 68:31–37
Kissling W, Möller HJ, Herberger B, Lehmann-Horn, Lauter H (in press) Double blind comparison of des-enkephaline-gamma-endorphine and haloperidol in acute schizophrenic patients. In: Burrows GD, Norman TR, Maguire KP (eds) Clinical and pharmacological studies in psychiatric disorders. Libbey, London
Klein HE (1986) The dexamethasone suppression test in psychiatry: Myth and realities. In: Burrows GD, Werry JS (eds) Advances in human psychopharmacology — research annual, vol IV. Jai Press, New York (in press)
Möller HJ, Kissling W, Bottermann P (1984a) Serial application of clonidine tests during antidepressive treatment with chlorimipramine. Pharmacopsychiatry 17:184–187
Möller HJ, Kissling W, Herberger B, Kuss HJ (1984b) Kontrollierte Studie über die möglichen Vorteile einer Kombinationstherapie mit Chlorimipramin und Haloperidol bei endogen Depressiven. Pharmacophsychiatry 17:29–33
Möller HJ, Kissling W, Herberger B, Binz U, Wendt G (1986) Controlled trial on the possible advantages of a combined therapy with maprotiline and haloperidol in endogenous depressives. Pharmacopsychiatry (in press)
Oxenkrug GF (1978) Dexamethasone test in alcoholics. Lancet 7:795
Papacostas Y, Fink M, Lee J, Irwin P, Janson L (1981) Neuroendocrine measures in psychiatric patients: Course and outcome with WCT. Psychiatr Res 4:55–64
Peselow ED, Goldring N, Fiewe RR, Wright R (1983) The dexamethasone suppression test in depressed outpatients and normal control subjects. Am J Psychiatry 140:245–247
Raskind M, Peskind E, Rivard MF (1982) Dexamethasone suppression test and cortisol circadian rhythm in primary degenerative dementia. Am J Psychiatry 139:1468–1471
Reus VJ, Joseph MS, Dallmann MF (1982) ACTH levels after the dexamethasone suppression test in depression. N Engl J Med 360:238–239
Rothschild AJ, Schatzberg AF (1982) Fluctuating postdexamethasone cortisol levels in a patient with melancholia. Am J Psychiatry 139:129–130
Rush J, Giles DE, Roffwarg HP, Parker CR (1982) Sleep EEG and dexamethasone suppression test findings in outpatients with unipolar major depressive disorder. Biol Psychiatry 17:327–341
Schlesser MA, Winokur G, Sherman BM (1979) Genetic subtypes of unipolar primary depressive illness distinguished by hypothalamic pituitary adrenal axis activity. Lancet I:739–741
Spar IE, Gerner R (1982) Does the dexamethasone suppression test distinguish dementia from depression. Am J Psychiatry 139:238–240
Swartz CM, Dunner FJ (1982) Dexamethasone suppression testing of alcoholics. Arch Gen Psychiatry 39:1309–1312
Zerseen D v, unter Mitarbeit von Koeller DM (1976) Klinische Selbstbeurteilungs-Skalen (KSb-S) aus dem Münchener Psychiatrischen Informationssystem (PSYCHIS München). Manuale. a) Allgemeiner Teil, b) Paranoid-Depressivitäts-Skale, c) Befindlichkeits-Skala, d) Beschwerden-Liste. Beltz, Weinheim
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Möller, H.J., Kissling, W. & Bottermann, P. The dexamethasone suppression test in depressive and schizophrenic patients under controlled treatment conditions. Eur Arch Psychiatr Neurol Sci 235, 263–268 (1986). https://doi.org/10.1007/BF00515912
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DOI: https://doi.org/10.1007/BF00515912