Coryell W, Noyes R, Clancy J, Crowe R, Chaudhry D
Psychiatry Res. 1985 Aug;15(4):301-11. doi: 10.1016/0165-1781(85)90067-8.
Patients who met DSM-III criteria for agoraphobia with panic attacks underwent dexamethasone suppression tests (DSTs) before, during, and after treatment with alprazolam or placebo. Similarly, outpatients with major depression were given multiple DSTs as they participated in a study of desmethylimipramine efficacy. The likelihood of an abnormal escape from dexamethasone was similar in the two diagnostic groups; nonsuppression was somewhat more likely among patients with primary depression, but comparisons with agoraphobic groups remained statistically insignificant. These results apparently did not reflect misclassification of primary depression patients as agoraphobics since a history of major depression was not related to the likelihood of nonsuppression within that group. Moreover, change in DST results during treatment reflected clinical change among agoraphobics. After a review of relevant followup and family studies, we conclude that panic disorder and primary depression are separate illnesses and that hypothalamic-pituitary-adrenal axis hyperactivity is an epiphenomenon of both.
符合《精神疾病诊断与统计手册第三版》（DSM - III）中伴有惊恐发作的广场恐惧症标准的患者，在接受阿普唑仑或安慰剂治疗前、治疗期间及治疗后接受了地塞米松抑制试验（DST）。同样，患有重度抑郁症的门诊患者在参与去甲丙咪嗪疗效研究时也接受了多次DST。在这两个诊断组中，地塞米松异常脱抑制的可能性相似；在原发性抑郁症患者中，非抑制现象略多一些，但与广场恐惧症组的比较在统计学上仍无显著差异。这些结果显然并非反映了将原发性抑郁症患者误分类为广场恐惧症患者，因为重度抑郁症病史与该组内非抑制的可能性无关。此外，治疗期间DST结果的变化反映了广场恐惧症患者的临床变化。在回顾了相关的随访和家族研究后，我们得出结论，惊恐障碍和原发性抑郁症是两种不同的疾病，下丘脑 - 垂体 - 肾上腺轴功能亢进是两者的一种附带现象。
