Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Mannheim, Germany.
Psychoneuroendocrinology. 2011 Jun;36(5):691-8. doi: 10.1016/j.psyneuen.2010.10.002. Epub 2010 Oct 28.
Diurnal (24-h) cortisol profiles were compared to DST and Dex/CRH test outcomes with regard to their discriminative power in depressive disorder. With regard to several statistical measures (effect sizes, area under the curve) we found 24-h cortisol profiles to better discriminate between healthy controls and inpatients with the melancholic subtype of depression compared to the DST and Dex/CRH test. In search of a shortened time interval we found the 2-h time window 1000-1200 h of the cortisol profile to be the one with the highest sensitivity (83.3%) and specificity (87.9%). The specificity of the DST was 93.3% and somewhat higher than that of the cortisol profiles and the Dex/CRH test (87.9% and 78.8.%, respectively). However, the sensitivity of the DST was very low (30.8%), in fact similar to that of the Dex/CRH test (30.8%), but much lower than that of the 1000-1200 h interval (83.3%). The assessment of cortisol in plasma is an easy to perform, cost-saving method for the evaluation of the HPA system activity, which may have a series of clinical and scientific implications for the depressive disorder.
我们比较了 24 小时皮质醇谱与 DST 和 Dex/CRH 试验结果，以评估其在抑郁症中的鉴别能力。根据几个统计指标（效应大小、曲线下面积），我们发现与 DST 和 Dex/CRH 试验相比，24 小时皮质醇谱更好地区分了健康对照组和伴有忧郁型抑郁症的住院患者。为了寻找更短的时间间隔，我们发现皮质醇谱的 1000-1200 h 2 小时时间窗具有最高的敏感性（83.3%）和特异性（87.9%）。DST 的特异性为 93.3%，略高于皮质醇谱和 Dex/CRH 试验（分别为 87.9%和 78.8%）。然而，DST 的敏感性非常低（30.8%），实际上与 Dex/CRH 试验相似（30.8%），但远低于 1000-1200 h 间隔（83.3%）。评估血浆中的皮质醇是一种简单易行、节省成本的方法，可以评估 HPA 系统的活性，这可能对抑郁症有一系列临床和科学意义。
