Coryell W, Schlesser M A
Psychiatry Res. 1983 Mar;8(3):179-89. doi: 10.1016/0165-1781(83)90061-6.
In the course of several studies of hypothalamic-pituitary-adrenal axis activity in depression, 43 patients presented on separate admissions with definite depression and, on both admissions, received dexamethasone suppression tests (DSTs). DST results were discordant across admissions in 21% of cases; among patients who were nonsuppressors on either admission, results were discordant in 40.9%. The correlation between postdexamethasone values obtained on two admissions was highly significant, however. Distinctions between bipolar and unipolar depression and between primary and secondary depression by rates of nonsuppression were inconsistently significant across admissions but were clearer when results from both admissions were pooled and patients with an abnormal DST on either admission were considered nonsuppressors. While abnormal escape from dexamethasone suppression occurs in a significant proportion of depressed patients, this phenomenon may only partially overlap the depressive syndrome in time. Negative DST results in patients with primary depression must be interpreted in this light.
在几项关于抑郁症患者下丘脑 - 垂体 - 肾上腺轴活动的研究过程中，43例患者分别因明确的抑郁症入院，且两次入院时均接受了地塞米松抑制试验（DST）。在21%的病例中，两次入院的DST结果不一致；在两次入院时任何一次为非抑制者的患者中，结果不一致的比例为40.9%。然而，两次入院时获得的地塞米松给药后的值之间的相关性非常显著。通过非抑制率区分双相抑郁和单相抑郁以及原发性抑郁和继发性抑郁，在不同次入院时的差异并不一致显著，但当将两次入院的结果汇总，且将任何一次入院时DST异常的患者视为非抑制者时，差异就更明显了。虽然相当一部分抑郁症患者存在地塞米松抑制异常逃逸现象，但这种现象在时间上可能仅与抑郁综合征部分重叠。原发性抑郁症患者DST结果为阴性时必须据此进行解释。
