Greden J F, Gardner R, King D, Grunhaus L, Carroll B J, Kronfol Z
Arch Gen Psychiatry. 1983 May;40(5):493-500. doi: 10.1001/archpsyc.1983.01790050019002.
Pilot studies suggest that changes in response to the dexamethasone suppression test (DST) in melancholic patients receiving antidepressants might represent a laboratory marker of clinical progress. We performed weekly DSTs in 31 hospitalized patients with major depressive disorder, primary and endogenous subtypes, during drug-free and subsequent treatment periods. Most nonsuppressors had progressive normalization of DST responses in conjunction with clinical improvement, DST normalization usually preceded or coincided with good clinical response, and failure to normalize was often associated with poorer clinical outcome. Occasional patients with baseline dexamethasone suppression become nonsuppressive after withdrawal from medication, but the DST has no apparent value as a serial marker in patients with well-documented normal DST findings. Our results extend the construct validity of the DST as a state-related marker in nonsuppressors and suggest future clinical applications.
初步研究表明，接受抗抑郁药治疗的忧郁症患者对地塞米松抑制试验（DST）的反应变化可能代表临床进展的实验室指标。我们对31例患有重度抑郁症、原发性和内源性亚型的住院患者在停药期和后续治疗期每周进行一次DST。大多数抑制试验无反应者的DST反应逐渐恢复正常，同时临床症状改善，DST正常化通常先于或与良好的临床反应同时出现，未能正常化往往与较差的临床结果相关。偶尔有基线地塞米松抑制的患者在停药后变为抑制试验无反应，但DST在DST结果已充分证明正常的患者中作为连续指标没有明显价值。我们的结果扩展了DST作为抑制试验无反应者中与状态相关指标的结构效度，并提出了未来的临床应用。
