地塞米松抑制试验：其与诊断、抑郁严重程度及治疗反应的关系。

The dexamethasone suppression test: its relationship to diagnoses, severity of depression and response to treatment.

Dratcu L, Calil H M

Department of Psychobiology, Escola Paulista de Medicina, São Paulo, Brazil.

Prog Neuropsychopharmacol Biol Psychiatry. 1989;13(1-2):99-117. doi: 10.1016/0278-5846(89)90007-9.

Abstract

The dexamethasone suppression test (DST) was applied to 40 depressed patients, 40 healthy volunteers and 40 patients with other psychiatric disorders. 2. The post-dexamethasone cortisol level, adopted as the non-suppression criterion and established locally, was 3.0 micrograms/dl. 3. The DST sensitivity in depression was 45%, with a specificity of 95% and a positive predictive value of 90%. 4. There was a significant correlation (r = 0.38, p less than 0.05) between HDRS scores of depressed patients and their post-dexamethasone cortisol levels. 5. A prospective study of the depressed group, which was assessed with three depression rating scales, showed differences between non-suppressors and suppressors regarding to the symptoms severity and response to the treatment. It suggests that an abnormal DST result could have a prognostic value to antidepressant drugs and ECT. 6. The DST specificity in depression was also calculated from its performance in the group with other psychiatric disorders, and their diagnoses as well as the abnormal DST results were critically discussed.

摘要

地塞米松抑制试验（DST）应用于40名抑郁症患者、40名健康志愿者和40名患有其他精神障碍的患者。2. 地塞米松给药后的皮质醇水平，作为非抑制标准并在当地确立，为3.0微克/分升。3. DST在抑郁症中的敏感性为45%，特异性为95%，阳性预测值为90%。4. 抑郁症患者的汉密尔顿抑郁量表（HDRS）评分与其地塞米松给药后的皮质醇水平之间存在显著相关性（r = 0.38，p < 0.05）。5. 对抑郁症组进行的前瞻性研究，用三种抑郁评定量表进行评估，结果显示非抑制者和抑制者在症状严重程度和对治疗的反应方面存在差异。这表明DST结果异常对抗抑郁药物和电休克治疗可能具有预后价值。6. DST在抑郁症中的特异性也根据其在患有其他精神障碍的组中的表现进行计算，并对他们的诊断以及异常的DST结果进行了批判性讨论。