[The prognostic value of the dexamethasone suppression test for the course of anorexia nervosa--comparison with depressive diseases].

In the light of studies in affective disorders the predictive potential of the Dexamethasone Suppression Test was investigated in 31 patients with anorexia nervosa. According to the Morgan and Russell general outcome score the follow-up was conducted one year after each patient's discharge from hospital. There was a highly significant association between the post-dexamethasone-cortisol-plasma-value in weight-corrected patients at discharge and the one year follow-up. Patients who did not normalize their DST responses were at higher risk for a poor outcome. In contrast to patients with pure malnutrition a number of weight-restored anorexic patients continue to show or return to nonsuppression. It appears that reversion to a positive DST result might reflect a stress response in patients who failed to recover completely though weight stabilisation during inpatient treatment. Stress may lead to hypersecretion of CRH, which is known to be a potent anorexic agent. The present study does not point to a common etiology of anorexia nervosa and affective disorders as nonsuppression in the DST might be an unspecific response to stress-related factors.