Grunhaus L, Zelnik T, Albala A A, Rabin D, Haskett R F, Zis A P, Greden J F
Department of Psychiatry, University of Michigan Medical Center, Ann Arbor 48109.
J Affect Disord. 1987 Nov-Dec;13(3):233-40. doi: 10.1016/0165-0327(87)90042-5.
Several systematic studies have evaluated serial dexamethasone suppression tests (DST) in patients with major depression who were treated with antidepressant medications. DST changes were noted to parallel clinical improvement in most recovering patients. If serial DSTs are a valid state-related correlate of depressive pathophysiology, all types of effective antidepressant treatment should result in DST 'normalization'. However, no treatment modalities other than antidepressant medications have been studied serially with systematic assessments. To test whether serial DSTs reflect clinical progress in depressives treated solely with electroconvulsive therapy (ECT), we studied weekly DSTs and Hamilton Rating Scales for Depression (HRSD) in 22 drug-free depressed patients. We observed progressive DST 'normalization' in most patients and moderately high correlations between weekly DST and HRSD values throughout treatment. Most patients receiving ECT became DST suppressors. In most patients the DST appeared to reflect the severity of depressive pathophysiology, perhaps providing serial feedback to clinicians monitoring the progress of treatment with ECT.
多项系统性研究评估了接受抗抑郁药物治疗的重度抑郁症患者的系列地塞米松抑制试验（DST）。在大多数病情好转的患者中，DST变化与临床改善情况平行。如果系列DST是与抑郁病理生理学相关的有效状态指标，那么所有类型的有效抗抑郁治疗都应导致DST“正常化”。然而，除抗抑郁药物外，尚未对其他治疗方式进行系统性系列评估研究。为了测试系列DST是否反映仅接受电休克治疗（ECT）的抑郁症患者的临床进展，我们对22名未服用药物的抑郁症患者进行了每周一次的DST和汉密尔顿抑郁量表（HRSD）研究。我们观察到大多数患者的DST逐渐“正常化”，且在整个治疗过程中，每周的DST与HRSD值之间存在中度高度相关性。大多数接受ECT治疗的患者成为DST抑制者。在大多数患者中，DST似乎反映了抑郁病理生理学的严重程度，这或许能为监测ECT治疗进展的临床医生提供系列反馈。
