Rubin R T, Poland R E, Lesser I M, Winston R A, Blodgett A L
Arch Gen Psychiatry. 1987 Apr;44(4):328-36. doi: 10.1001/archpsyc.1987.01800160032006.
To examine both predexamethasone and postdexamethasone cortisol measures in depression, we determined circadian serum cortisol patterns, cortisol responses to dexamethasone, and 24-hour urinary free cortisol excretion before and after dexamethasone administration in 40 patients with primary, definite endogenous depression diagnosed by Research Diagnostic Criteria and in 40 individually matched normal control subjects. Fifteen patients (38%) were dexamethasone nonsuppressors; they had significantly higher predexamethasone serum and urine cortisol measures than both their matched controls and the 25 suppressor patients. Both the predexamethasone and postdexamethasone cortisol measures were unimodally distributed across the patients and the controls. Circadian cortisol rhythms of similar magnitude occurred in both groups. The cortisol measures before and after dexamethasone administration were positively correlated to a similar degree in the patients and their controls, suggesting that predexamethasone hypothalamic-pituitary-adrenocortical hyperactivity and postdexamethasone cortisol nonsuppression are not independently determined in endogenous depression.
为研究抑郁症患者地塞米松给药前和给药后皮质醇的测量值，我们测定了40例经研究诊断标准确诊的原发性、明确的内源性抑郁症患者以及40例个体匹配的正常对照者的昼夜血清皮质醇模式、皮质醇对地塞米松的反应，以及地塞米松给药前后24小时尿游离皮质醇排泄量。15例患者（38%）为地塞米松不抑制者；他们给药前的血清和尿皮质醇测量值显著高于其匹配的对照者以及25例抑制者患者。给药前和给药后的皮质醇测量值在患者和对照者中均呈单峰分布。两组的昼夜皮质醇节律幅度相似。地塞米松给药前后的皮质醇测量值在患者及其对照者中具有相似程度的正相关，这表明内源性抑郁症中给药前下丘脑-垂体-肾上腺皮质功能亢进和给药后皮质醇不抑制并非独立决定。
