Gitlin M J, Gerner R H
J Clin Psychiatry. 1986 Jan;47(1):16-21.
The dexamethasone suppression test (DST) has been primarily investigated as an aid in diagnosing endogenous depression; yet, its major clinical use has been as a predictor of treatment response. It is commonly held that 1) an abnormal DST predicts response to somatic (and not psychologic) therapies, 2) an abnormal DST predicts response to noradrenergic antidepressants, and 3) a normal DST predicts response to serotonergic agents. The DST predicted response to somatic therapies in only 6 of 16 published studies. No single methodologic factor, such as population variables, DST technique, or study design, can explain the marked discrepancy in study results. Only two of seven studies examining the DST and response to neurotransmitter-specific antidepressant groups found a positive relationship. The evidence that the DST predicts response to noradrenergic agents is weak. The DST does not predict acute response to somatic treatment in general or response to specific antidepressants. The selection of the appropriate treatment for depressed patients is still best made using clinical criteria.
地塞米松抑制试验（DST）主要用于辅助诊断内源性抑郁症；然而，其主要临床用途是作为治疗反应的预测指标。人们普遍认为：1）异常的DST预测对躯体（而非心理）治疗的反应；2）异常的DST预测对去甲肾上腺素能抗抑郁药的反应；3）正常的DST预测对血清素能药物的反应。在16项已发表的研究中，DST仅在6项研究中预测了对躯体治疗的反应。没有单一的方法学因素，如人群变量、DST技术或研究设计，能够解释研究结果中的显著差异。在7项研究DST与对神经递质特异性抗抑郁药组反应的研究中，只有两项发现了正相关关系。DST预测对去甲肾上腺素能药物反应的证据不足。DST一般不能预测对躯体治疗的急性反应或对特定抗抑郁药的反应。对于抑郁症患者，选择合适的治疗方法仍最好依据临床标准。
