Devanand D P, Decina P, Sackeim H A, Hopkins N, Novacenko H, Malitz S
Biol Psychiatry. 1987 Apr;22(4):463-72. doi: 10.1016/0006-3223(87)90168-5.
Four different methods of quantifying the 1-mg Dexamethasone Suppression Test (DST) were contrasted with serial testing in endogenous depressives receiving electroconvulsive therapy (ECT). Of three continuous measures in 38 patients with pretreatment DSTs, only the log-transformed value for plasma cortisol was normally distributed, indicating that it possessed superior psychometric properties. Pretreatment Hamilton Depression Rating Scores (HAM-D) correlated positively with pretreatment DST status, with a similar association noted between posttreatment DST status and HAM-D scores. There was no uniform effect of ECT on the DST. Although pretreatment nonsuppressors showed a trend toward decreased postdexamethasone cortisol values, initial suppressors (cutoff: 5 micrograms/dl) evidenced a significant increase in these values, and 35.3% of initial suppressors were nonsuppressors at final DST assessment. These trends were noted in the DST assessment done following the third ECT treatment, suggesting an effect of regression to the mean. The findings highlight the importance of following initial DST suppressors in studies of this type.
对接受电休克治疗（ECT）的内源性抑郁症患者进行连续测试，对比了四种不同的1毫克地塞米松抑制试验（DST）量化方法。在38例进行过治疗前DST的患者的三项连续测量指标中，只有血浆皮质醇的对数转换值呈正态分布，表明其具有更好的心理测量特性。治疗前汉密尔顿抑郁量表评分（HAM-D）与治疗前DST状态呈正相关，治疗后DST状态与HAM-D评分之间也有类似关联。ECT对DST没有一致的影响。虽然治疗前未被抑制者的地塞米松后皮质醇值有下降趋势，但初始被抑制者（临界值：5微克/分升）的这些值显著升高，且在最终DST评估时，35.3%的初始被抑制者变为未被抑制者。这些趋势在第三次ECT治疗后的DST评估中被注意到，提示存在均值回归效应。这些发现突出了在这类研究中跟踪初始DST被抑制者的重要性。
