Mullen P E, Linsell C R, Parker D
Lancet. 1986 Nov 8;2(8515):1051-5. doi: 10.1016/s0140-6736(86)90463-0.
The hypothesis that the dexamethasone suppression test (DST) and rapid-eye-movement (REM) latency test are not biological markers for depressive illness but artifacts arising from dietary and sleep disturbances that accompany depression was examined in 28 normal volunteers. The restriction of calorie intake with moderate weight loss reproduced a pattern of response to dexamethasone closely resembling that claimed to be diagnostic of depressive illness. The shortened REM latencies claimed as a diagnostic marker were replicated in volunteers by mimicking the sleep pattern commonly found in depression. These changes could not be explained by the induction of mood disorder in the subjects. The results put in question the diagnostic value of the DST and REM latency tests in clinical practice, where sleep disorder and poor appetite, with reduced calorie intake, are the common accompaniments of depressive illness.
在28名正常志愿者中,对“地塞米松抑制试验(DST)和快速眼动(REM)潜伏期试验并非抑郁症的生物学标志物,而是由抑郁症伴随的饮食和睡眠障碍所产生的假象”这一假说进行了检验。通过适度减重来限制热量摄入,重现了一种对地塞米松的反应模式,该模式与据称可诊断抑郁症的模式极为相似。通过模拟抑郁症中常见的睡眠模式,在志愿者身上复制了被认为是诊断标志物的缩短的REM潜伏期。这些变化无法用受试者情绪障碍的诱发来解释。研究结果对DST和REM潜伏期试验在临床实践中的诊断价值提出了质疑,在临床实践中,睡眠障碍和食欲不佳以及热量摄入减少是抑郁症常见的伴随症状。