Ansseau M, Scheyvaerts M, Doumont A, Poirrier R, Legros J J, Franck G
Psychiatry Res. 1984 Jul;12(3):261-72. doi: 10.1016/0165-1781(84)90031-3.
In a sample of 12 major depressive inpatients, endogenous subtype (8 primary and 4 secondary) defined by Research Diagnostic Criteria, we compared the sensitivity of four potential biological markers: latency of rapid eye movement (REM) sleep (recorded during at least 4 consecutive nights), dexamethasone suppression, and the clonidine and apomorphine tests. Shortened REM latency (less than 50 minutes during at least 1 night) identified 67% of depressives (87% of primary and 25% of secondary); nonsuppression after dexamethasone identified 50% of depressives (62% of primary and 25% of secondary); blunted growth hormone (GH) response after clonidine identified 75% of depressives (100% of primary and 25% of secondary); and blunted GH response after apomorphine identified 42% of depressives (62% of primary and 0% of secondary). Ninety-two percent of patients were correctly identified by at least one biological marker (100% of primary and 75% of secondary depressives). Of 67% of patients positive on at least two biological markers, all were primary depressives (100%). These four biological markers do not necessarily identify the same population, suggesting that their concurrent use may yield the highest level of diagnostic sensitivity.
在一组由研究诊断标准定义的12例重度抑郁住院患者样本中，内源性亚型（8例原发性和4例继发性），我们比较了四种潜在生物学标志物的敏感性：快速眼动（REM）睡眠潜伏期（至少连续4晚记录）、地塞米松抑制试验以及可乐定和阿扑吗啡试验。缩短的REM潜伏期（至少1晚少于50分钟）识别出67%的抑郁症患者（原发性患者中的87%和继发性患者中的25%）；地塞米松试验后不被抑制识别出50%的抑郁症患者（原发性患者中的62%和继发性患者中的25%）；可乐定试验后生长激素（GH）反应迟钝识别出75%的抑郁症患者（原发性患者中的100%和继发性患者中的25%）；阿扑吗啡试验后GH反应迟钝识别出42%的抑郁症患者（原发性患者中的62%和继发性患者中的0%）。至少一种生物学标志物能正确识别92%的患者（原发性抑郁症患者中的100%和继发性抑郁症患者中的75%）。在至少两种生物学标志物呈阳性的67%的患者中，全部为原发性抑郁症患者（100%）。这四种生物学标志物不一定能识别同一人群，这表明它们同时使用可能会产生最高水平的诊断敏感性。
