Korzekwa M, Steiner M, Links P, Eppel A
McMaster University, Hamilton, Ontario.
Can J Psychiatry. 1991 Feb;36(1):26-8. doi: 10.1177/070674379103600106.
The relationship between borderline personality disorders (BPD) and major depressive disorder (MDD) continues to be controversial. A reliable biological marker for depressed BPD patients would not only support the diagnosis but could also help in predicting treatment outcome. A large sample of psychiatric patients was screened and data on the Dexamethasone Suppression Test (DST) were obtained for 67 patients who met the criteria for BPD by scoring 7 or greater on the Diagnostic Interview for Borderlines. The DST was positive in 23.9% of the cases. Fifty cases of BPD also met the Research Diagnostic Criteria for MDD. The DST was positive in 26.0%. Of the 50 patients with MDD, 34 also met the criteria for endogenous depression. Only 17.6% of this subgroup had positive results on the DST. The low sensitivity and specificity of the DST for depression in BPD patients suggests that the DST is not a useful test in differentiating BPD patients with MDD from those without MDD. The possible reasons for the DST not being useful in this population are discussed. These findings raises further questions about the nature of the depression suffered by BPD patients.
边缘型人格障碍（BPD）与重度抑郁症（MDD）之间的关系一直存在争议。对于患有抑郁症的BPD患者而言，一种可靠的生物学标志物不仅有助于诊断，还能辅助预测治疗效果。研究人员对一大群精神科患者进行了筛查，并针对67名通过《边缘型人格诊断访谈》得分7分及以上而符合BPD标准的患者，获取了地塞米松抑制试验（DST）的数据。结果显示，23.9%的病例DST呈阳性。50例BPD患者同时符合MDD的研究诊断标准，其中DST阳性率为26.0%。在这50例MDD患者中，有34例还符合内源性抑郁症的标准，而该亚组中只有17.6%的患者DST结果呈阳性。DST对BPD患者抑郁症的低敏感性和特异性表明，DST在区分伴有MDD的BPD患者和不伴有MDD的BPD患者方面并非有效检测方法。本文讨论了DST在此类人群中无效的可能原因。这些发现进一步引发了关于BPD患者所患抑郁症本质的问题。
