Carroll B J, Feinberg M, Greden J F, Tarika J, Albala A A, Haskett R F, James N M, Kronfol Z, Lohr N, Steiner M, de Vigne J P, Young E
Arch Gen Psychiatry. 1981 Jan;38(1):15-22. doi: 10.1001/archpsyc.1981.01780260017001.
Four hundred thirty-eight subjects underwent an overnight dexamethasone suppression test (DST) to standardize the test for the diagnosis of melancholia (endogenous depression). Abnormal plasma cortisol concentrations within 24 hours after dexamethasone administration occurred almost exclusively in melancholic patients. The best plasma cortisol criterion concentration, above which a DST result may be considered abnormal, was 5 microgram/dL. The optimal dose of dexamethasone was 1 rather than 2 mg. Two blood samples obtained at 4 and 11 PM after dexamethasone administration detected 98% of the abnormal test results. This version of the DST identified melancholic patients with a sensitivity of 67% and a specificity of 96%. Baseline nocturnal plasma cortisol concentrations were not useful. Abnormal DST results were found with similar frequency among outpatients and inpatients with melancholia; but they were not related to age, sex, recent use of psychotropic drugs, or severity of depressive symptoms. Extensive evidence validates this practical test for the diagnosis of melancholia.
438名受试者接受了过夜地塞米松抑制试验（DST），以规范用于诊断忧郁症（内源性抑郁症）的该试验。地塞米松给药后24小时内血浆皮质醇浓度异常几乎仅发生在忧郁症患者中。地塞米松给药后血浆皮质醇的最佳标准浓度为5微克/分升，高于此浓度时DST结果可能被视为异常。地塞米松的最佳剂量为1毫克而非2毫克。地塞米松给药后下午4点和11点采集的两份血样检测出了98%的异常试验结果。此版本的DST识别忧郁症患者的灵敏度为67%，特异度为96%。基线夜间血浆皮质醇浓度并无用处。门诊和住院忧郁症患者中异常DST结果的出现频率相似；但它们与年龄、性别、近期精神药物使用情况或抑郁症状严重程度无关。大量证据证实了这项用于诊断忧郁症的实用试验。
