Albala A A, Greden J F, Tarika J, Carroll B J
Biol Psychiatry. 1981 Jun;16(6):551-60.
An abnormal dexamethasone suppression test (DST) identifies endogenous depressive with 95% confidence. The DST normalizes with successful treatment. Serial DSTs throughout treatment could provide useful information on (i) whether they biologically monitor clinical response, (ii) when DST normalization does occur, and (iii) whether early normalization predicts clinical outcome. We studied six inpatients who had abnormal DSTs on admission and serial DSTs during and after a course of ECT. All were diagnosed as unipolar major depressive disorder, endogenous (RDC). Clinical improvement was monitored with weekly Hamilton Rating Scales. Five of six abnormal DST patients converted to a normal test and showed significant clinical improvement. On patient failed to normalize and also had a poor outcome. All DST normalizations occurred by the fourth to sixth ECT. Additional ECTs resulted in further reduction in DST plasma cortisol values. All normalizers experienced progressive clinical improvement, and the DST successfully monitored these changes. DST conversion occurred early in treatment. Early DST normalization may have predictive value for good treatment response.
异常地塞米松抑制试验（DST）能以95%的置信度识别内源性抑郁症。治疗成功后DST会恢复正常。整个治疗过程中的系列DST可为以下方面提供有用信息：（i）它们是否能从生物学角度监测临床反应，（ii）DST何时恢复正常，以及（iii）早期恢复正常是否能预测临床结果。我们研究了6名入院时DST异常且在接受一个疗程的ECT期间及之后进行系列DST检查的住院患者。所有患者均被诊断为内源性单相重度抑郁症（研究诊断标准）。每周用汉密尔顿评定量表监测临床改善情况。6名DST异常患者中有5名DST转为正常且临床有显著改善。1名患者未恢复正常且预后不佳。所有DST恢复正常均发生在第4至第6次ECT时。额外的ECT导致DST血浆皮质醇值进一步降低。所有恢复正常者临床逐步改善，且DST成功监测到了这些变化。DST在治疗早期就发生了转变。早期DST恢复正常可能对良好的治疗反应具有预测价值。
