Bailly D, Goudemand M, Parquet P J
Encephale. 1984;10(4):155-69.
Within the investigation of the neuroendocrinology of depression, the HPA axis exploration brings the most definite results. Biological measurements indicate an hyperactivity of this system in the endogenous depressions. The dexamethasone cortisol suppression test has been described by Liddle and Nugent and has been used by Carroll since 1970. A standardisation of the protocol is required; thus, within the endogenous deficiencies, either lack of cortisol suppression or cortisol suppression with an early escape are noticed. The various and hazardous reasons that make the results vary are discussed. The dexamethasone suppression test is a practical and useful tool for the diagnosis of endogenous depression (sensitivity above 65%, specificity and diagnostical value near 95%); for treatment management; and prognostic evaluation. From a theoretical aspect, the dexamethasone test enables us to delineate the nosology of the depressive disorder and to detect in childhood depression the same neuro-endocrinological features as noticed in adulthood depression. Physiopathological hypotheses within the norepinephrinergic and serotoninergic depression theories are detailed.
在对抑郁症神经内分泌学的研究中，对下丘脑-垂体-肾上腺（HPA）轴的探索带来了最明确的结果。生物学测量表明，该系统在内源性抑郁症中存在功能亢进。地塞米松皮质醇抑制试验由利德尔和纽金特描述，自1970年以来卡罗尔一直在使用。需要对该方案进行标准化；因此，在内源性缺陷中，要么观察到皮质醇抑制缺乏，要么观察到早期逃逸的皮质醇抑制。讨论了导致结果变化的各种危险因素。地塞米松抑制试验是诊断内源性抑郁症的实用且有用的工具（敏感性高于65%，特异性和诊断价值接近95%）；用于治疗管理和预后评估。从理论方面来看，地塞米松试验使我们能够描绘出抑郁症的分类学，并在儿童抑郁症中检测到与成人抑郁症中相同的神经内分泌特征。去甲肾上腺素能和5-羟色胺能抑郁症理论中的病理生理假设也进行了详细阐述。
