101. Pretreatment DST and hypothalamic-pituitary-adrenocortical function in depressed patients and comparison groups. A multicenter study.
- Author
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Stokes PE, Stoll PM, Koslow SH, Maas JW, Davis JM, Swann AC, and Robins E
- Subjects
- Adult, Age Factors, Bipolar Disorder blood, Bipolar Disorder diagnosis, Bipolar Disorder physiopathology, Body Weight, Clinical Trials as Topic, Depressive Disorder blood, Depressive Disorder physiopathology, Female, Humans, Hydrocortisone cerebrospinal fluid, Hydrocortisone urine, Hypothalamo-Hypophyseal System physiology, Hypothalamo-Hypophyseal System physiopathology, Male, Middle Aged, Pituitary-Adrenal System physiology, Pituitary-Adrenal System physiopathology, Sex Factors, Depressive Disorder diagnosis, Dexamethasone, Hydrocortisone blood
- Abstract
Pretreatment measures of hypothalamic-pituitary-adrenocortical (HYPAC) function in depressed, manic, and healthy normal subjects showed that nonsuppression on the dexamethasone suppression test (DST) had less positive predictive value for major diagnostic category and was more frequent in normals (8/77) than recently reported, although it was yet more frequent in depressed patients (35/111). Nonsuppression was common in manics (8/16), was similar in unipolar and bipolar depressed patients (35% and 27%, respectively), and did not segregate with melancholic, endogenous, or psychotic depression subtypes. Patterns of post-DST plasma cortisol concentration other than simple escape or nonescape from suppression were common. Nonsuppression of 9 AM plasma cortisol levels on the DST had as good or better diagnostic specificity as nonsuppression of any of three post-DST samples. Nonsuppression was not completely synonymous with HYPAC hypersecretion. Means of pre-DST HYPAC measures (morning plasma cortisol, urine free cortisol, and CSF cortisol levels) were elevated in depressed patients compared with normals. There were significant differences in HYPAC measures of depressed patients studied at different centers. Age correlated positively and body weight negatively with plasma cortisol level.
- Published
- 1984
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