Fogel B S, Satel S L, Levy S
Psychiatry Res. 1985 Jun;15(2):85-90. doi: 10.1016/0165-1781(85)90043-5.
The authors retrospectively studied 161 psychiatric inpatients who had received a dexamethasone suppression test (DST). The majority of the patients were over 60 years old, female, and had concurrent chronic medical illnesses. Age was significantly correlated with log-transformed postdexamethasone cortisol concentrations in the 118 nondemented patients with major depression. Four p.m. cortisol concentrations greater than 15 micrograms/dl occurred in 15 patients. All were over 60 years old; all but one had major depressive disorder (MDD); and five had dementia plus MDD. In the same population, a 5 micrograms/dl criterion did not distinguish MDD from non-MDD patients. The results support the existence of a clinically relevant age effect on the DST in patients with MDD. Elderly depressed patients with markedly elevated cortisol concentrations occur frequently, and warrant further clinical and pathophysiological study.
作者回顾性研究了161例接受地塞米松抑制试验（DST）的精神科住院患者。大多数患者年龄超过60岁，为女性，且患有并发慢性疾病。在118例非痴呆的重度抑郁症患者中，年龄与地塞米松后皮质醇浓度的对数转换值显著相关。15例患者下午4点的皮质醇浓度大于15微克/分升。所有患者均年龄超过60岁；除1例患者外，其余均患有重度抑郁症（MDD）；5例患有痴呆症合并MDD。在同一人群中，以5微克/分升为标准无法区分MDD患者与非MDD患者。结果支持在MDD患者中，年龄对DST存在临床相关影响。皮质醇浓度明显升高的老年抑郁症患者很常见，值得进一步进行临床和病理生理学研究。
