Cottraux J A, Bouvard M, Claustrat B, Juenet C
Psychiatry Res. 1984 Oct;13(2):157-65. doi: 10.1016/0165-1781(84)90059-3.
The dexamethasone suppression test (DST) was administered after baseline cortisol measurements in 20 patients (10 males, 10 females) who met DSM-III criteria for obsessive-compulsive disorder (OCD). Six patients (30%) showed an abnormal escape from dexamethasone suppression. DST suppressors vs. DST nonsuppressors showed no differences on age, rate of secondary depressive disorders, or scores on the Hamilton Rating Scale for Depression, the Minnesota Multiphasic Personality Inventory D scale, or OCD rating scales. Surprisingly, there was a trend for suppressors to have a stronger family history of depressive disorders, and for nonsuppressors to include an excess of male subjects. Moreover, there was a significant correlation between levels of cortisol before and after DST. In five of six nonsuppressors, both depressive symptoms and obsessive-compulsive behaviors showed a diminution in response to antidepressant therapy combined, in one case, with intensive behavior therapy. The relationships between OCD and endogenous depression, as well as the specificity of the DST, are discussed.
在20名符合《精神疾病诊断与统计手册》第三版（DSM-III）强迫症（OCD）标准的患者（10名男性，10名女性）中，在测量基础皮质醇水平后进行了地塞米松抑制试验（DST）。6名患者（30%）显示地塞米松抑制试验结果异常。地塞米松抑制试验抑制者与非抑制者在年龄、继发性抑郁症发生率或汉密尔顿抑郁量表评分、明尼苏达多相人格调查表D量表评分或强迫症评定量表评分方面均无差异。令人惊讶的是，抑制者有更强的抑郁症家族史倾向，而非抑制者中男性受试者过多。此外，地塞米松抑制试验前后的皮质醇水平之间存在显著相关性。在6名非抑制者中的5名中，抑郁症状和强迫行为在联合抗抑郁治疗（在1例中联合强化行为治疗）后均有所减轻。本文讨论了强迫症与内源性抑郁症之间的关系以及地塞米松抑制试验的特异性。
