The dexamethasone suppression test in bulimic outpatients without major depression

1992 ◽  
Vol 7 (2) ◽  
pp. 85-89
Author(s):  
D Bailly ◽  
N Regnaut ◽  
PJ Parquet

SummaryRecent studies have examined the effectiveness of the dexamethasone suppression test (DST) in the evaluation of bulimia. In a series of 18 female bulimic outpatients without major depression, 9 (50%) failed to suppress on the DST. No significant difference was found between suppressors and nonsuppressors in personal and family histories of affective disorder, levels of anxious and depressive symptoms, psychoactive substance abuse, and severity of abnormal eating-related behaviours. In contrast, non-suppression was significantly associated with low weight. There is a trend to differentiate non-suppressors from suppressors in the current diagnosis of anorexia nervosa and in past history of anorexia nervosa. Seven patients received fluvoxamine for 8 weeks. Five patients were suppressors and showed a significant decrease in the frequency of their binges while the 2 non-suppressors did not improve. These preliminary results suggest that DST non-suppression might be typical of bulimic patients with anorexia nervosa and that pretreatment DST results might predict the response of bulimic behaviour to treatment with fluvoxamine.

1984 ◽  
Vol 145 (1) ◽  
pp. 88-90 ◽  
Author(s):  
Alec Coppen ◽  
Janet Harwood ◽  
Keith Wood

SummaryThe dexamethasone suppression test (DST) was carried out on 143 patients with a major depressive disorder, who were classified into those with a history of weight loss (n = 89) and those without (n = 54). Seventy-three per cent of patients with weight loss and 61% of patients without had an abnormal DST; this difference was not statistically significant. Of the patients receiving prophylactic lithium therapy, 13 were found to have changed their DST status on retesting after a period of 14 months, but there was no significant difference in their weight. It is concluded that weight loss is not a necessary condition for an abnormal DST in depressive illness.


1994 ◽  
Vol 9 (6) ◽  
pp. 281-287 ◽  
Author(s):  
C Gastó ◽  
J Vallejo ◽  
JM Menchón ◽  
R Catalán ◽  
A Otero ◽  
...  

SummaryPlatelet serotonin-binding (Bmax), using tritiated-seroionin as the ligand, was determined in 75 patients suffering from major depression with melancholia and in 26 patients diagnosed from dysthymic disorder. Twenty-five normal subjects were used as a control group. The melancholic group had significantly lower Bmax values (mean: 6.7 ± 6.1 pmol/108 platelets) than either dysthymic (9.3 ± 3.9 pmol/108 platelets) or control (9.2 ± 4.8 pmol/108 platelets) groups, while there were no significant differences between the two latter groups. There was also a significant difference on postdexamethasone Cortisol between melancholic (6.3 ± 7.1 μg/dL) and dysthymic (1.4 ± 1.4 μg/dL) groups, with a higher rate of nonsuppressors in melancholic groups. Although both tests were abnormal in the melancholic group, no relationship was found between platelet serotonin-binding and the dexaniethasone suppression test.


1988 ◽  
Vol 152 (5) ◽  
pp. 654-656 ◽  
Author(s):  
G. O'Brien ◽  
F. Hassanyeh ◽  
A. Leake ◽  
K. Schapira ◽  
M. White ◽  
...  

In a study of the dexamethasone suppression test (DST) in patients with bulimia nervosa, a non-suppression rate of about 50% was found. The only clinical correlates of DST non-suppression were a previous history of weight loss and/or of anorexia nervosa. These results suggest that DST non-suppression in these subjects may be a trait rather than a state marker of anorexia nervosa.


1986 ◽  
Vol 149 (6) ◽  
pp. 751-755 ◽  
Author(s):  
I. Schweitzer ◽  
K. P. Maguire ◽  
J. W. G. Tiller ◽  
A. H. Gee ◽  
L. C. Harrison ◽  
...  

Prior studies on weight change and hypothalmic-pituitary-adrenal (HPA) axis functioning are reviewed. Data on 58 depressed and eight anorexic patients is presented. No significant difference in the frequency of cortisol non-suppression in the dexamethasone suppression test (DST) was found between depressed patients with a history of weight loss and those without, nor between depressed patients who lost weight during their first week in hospital and those who did not. Mean weight loss of suppressors did not significantly differ from that of non-suppressors. Of 12 patients whose DST normalised during their stay in hospital, only four gained weight. Five anorexics who were non-suppressors were <70% of their ideal body weight (IBW), while three suppressor anorexics were ≧70% IBW. These results indicate that mild to moderate weight change is not a significant influence on DST response in depression.


2005 ◽  
Vol 50 (6) ◽  
pp. 342-345 ◽  
Author(s):  
Konstantinos N Fountoulakis ◽  
Stergios G Kaprinis ◽  
Apostolos Iacovides ◽  
Konstantinos Phokas ◽  
George Kaprinis

Objective: Recent data suggest that the low thyroid function syndrome in depression is nonspecific, They also suggest that depression may constitute a risk factor for the development of dementia, especially in atypical patients who have high rates of hypothalamo–pituitary–adrenal axis disorders. This study aimed to search for correlations among Dexamethasone Suppression Test (DST) cortisol levels, thyroid indices, and family history of dementia in patients with depression. Methods: A sample of 30 patients, aged 21 to 60 years and suffering from major depression according to DSM-IV criteria, took part in the study. Three had a family history of dementia in first-degree relatives. We measured their serum levels of free T3, free T4, thyroid-stimulating hormone, thyroid binding inhibitory immunoglobulines, thyroglobulin antibodies, and thyroid microsomal antibodies (TMAs). We applied the 1-mg DST to all patients. The statistical analysis included 1-way multivariate analysis of covariance using t tests as the post hoc tests. Results: Significantly higher levels of TMAs were found in patients with a family history of dementia, compared with those who did not have this family history. Conclusion: The results of this study suggest that a more pronounced autoimmune process may characterize depression patients with a family history of dementia.


1998 ◽  
Vol 13 (8) ◽  
pp. 411-418 ◽  
Author(s):  
C Massoubre ◽  
F Lang ◽  
L Millot ◽  
M Pichon ◽  
B Estour ◽  
...  

SummaryThis study was conducted to investigate the corticotropic axis in anorexia nervosa. In 93 female inpatients who met DSM-III-R criteria for anorexia nervosa, subsample (n = 64) with DSM-III criteria was also considered. Using stepwise regression analysis, this study examined the relationship between independent variables ie, age, body mass index, scores on depression scales and postdexamethasone serum cortisol, considered as a dependent variable. In patients who met DSM-III criteria, 16.7% of the variance of serum cortisol can be explained. The main predictors are depressive retardation, emaciation and age. Using stepwise logistic regression the main categorical predictors of the test suppression vs non suppression are of the same nature. The condition of realisation of DST are discussed.


2021 ◽  
Vol 14 (8) ◽  
pp. e244258
Author(s):  
Annalisa Montebello ◽  
Etienne Ceci Bonello ◽  
Miriam Giordano Imbroll ◽  
Mark Gruppetta

A 55-year-old woman presented with a 4-month history of right-sided non-specific loin pain and 6 kg weight loss. A CT scan of the abdomen and pelvis showed an incidental 4.5 cm right-sided adrenal lesion which was not typical of an adrenal adenoma. This was further confirmed on MRI of the adrenals. Biochemical investigations to investigate for a functional adrenal lesion included serum catecholamines and metanephrines, an aldosterone to renin ratio and an overnight dexamethasone suppression test. These were all negative. A laparoscopic adrenalectomy was performed in view of the large size of the lesion. Histology was consistent with a phaeochromocytoma, which confirmed the diagnosis of a non-secreting phaeochromocytoma. Non-secreting phaeochromocytomas are rare and usually found in patients with known genetic mutations. Adrenal lesions not related to any mutations similar to our case are even rarer and reported even less in the literature.


1988 ◽  
Vol 153 (5) ◽  
pp. 689-692 ◽  
Author(s):  
J. C. Powell ◽  
W. R. Silveira ◽  
R. Lindsay

A case of childhood affective disorder with episodes of depressive stupor in a 13-year-old pre-pubertal boy is described. Changes in the patient's clinical state were accompanied by changes in the dexamethasone suppression test. A family history of affective illness on the maternal side, with phenomenological similarities, is noted.


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