Harvey S A, Black K J
Department of Psychiatry, Washington, University School of Medicine, St. Louis, Missouri 63110, USA.
Ann Clin Psychiatry. 1996 Mar;8(1):35-9. doi: 10.3109/10401239609149090.
Depression following a cerebrovascular accident is common, disabling, and treatable. However, the consequences of a stroke often render the clinical evaluation for depression misleading or difficult to interpret. These factors make a laboratory test for depression especially desirable in this population. We reviewed and evaluated the literature on the dexamethasone suppression test (DST) as a diagnostic tool for depression in stroke patients. Nine studies were identified. Our findings included (1) substantial variation in both methods and results, (2) a median specificity of 87%, and (3) a median sensitivity of 47%. We show that if these estimates of sensitivity and specificity are supported by future studies with improved methodology, then the DST may be clinically useful for the minority of stroke patients in whom a careful evaluation for depression remains inconclusive.
脑血管意外后出现的抑郁很常见，会导致残疾，且可治疗。然而，中风的后果常常使抑郁症的临床评估产生误导或难以解释。这些因素使得针对该人群进行抑郁症实验室检测尤为必要。我们回顾并评估了有关地塞米松抑制试验（DST）作为中风患者抑郁症诊断工具的文献。共确定了9项研究。我们的研究结果包括：（1）方法和结果存在很大差异；（2）中位特异性为87%；（3）中位敏感性为47%。我们表明，如果这些敏感性和特异性估计值得到方法改进的未来研究的支持，那么DST可能对少数抑郁症仔细评估仍无定论的中风患者具有临床实用价值。
