The Use of the Dexamethasone Suppression Test in the Differential Diagnosis of Catatonic Stupor

1983 ◽  
Vol 12 (2) ◽  
pp. 93-101 ◽  
Author(s):  
Ronald C. Bloodworth
Keyword(s):  
Affective Disorder ◽  
Affective Disorders ◽  
Dexamethasone Suppression Test ◽  
Psychiatric Institute ◽  
Disease Entity ◽  
Conversion Disorders ◽  
Catatonic Schizophrenia ◽  
Organic Brain ◽  
Suppression Test ◽  
Dexamethasone Suppression

Catatonic stupor is a cluster of symptoms and not necessarily a disease entity. It may be seen not only in schizophrenia, but in major affective disorders, conversion disorders, organic brain syndromes, and atypical psychoses. The dexamethasone suppression test is a valuable tool in the diagnosis of major affective disorders, differentiating them from other types of psychopathology. In a twelve month retrospective study, five patients admitted to Psychiatric Institute of Atlanta were identified as meeting the criteria for catatonic schizophrenia. A dexamethasone suppression test was performed shortly after admission. Four of the five had patterns of inadequate suppression, indicative of a major affective disorder rather than a schizophrenic disorder. The dexamethasone suppression test is simple to administer, relatively painless, free from hazards, easy to interpret, readily available, and reliable. Not only can the dexamethasone suppression test be used in diagnosis, but also as a valuable aid in following the therapeutic progress in resolution of a major affective disorder.

Dexamethasone Suppression Test in Depression and other Psychiatric Illness

1983 ◽  
Vol 142 (5) ◽  
pp. 498-504 ◽  
Author(s):  
A. Coppen ◽  
M. Abou-Saleh ◽  
P. Milln ◽  
M. Metcalfe ◽  
J. Harwood ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Affective Disorders ◽  
Psychiatric Illness ◽  
Dexamethasone Suppression Test ◽  
Major Depressive ◽  
Abnormal Response ◽  
Suppression Test ◽  
Dexamethasone Suppression ◽  
Normal Controls

SummaryThe prevalence of an abnormal response to the dexamethasone suppression test (DST) was examined in 119 in-patients suffering from a major depressive disorder and in 79 normal controls. Only 11 per cent of controls showed an abnormal DST as against 70 per cent of depressed patients. The specificity of the DST was examined by testing patients with other psychiatric disorders. Abnormal responses were found in one-fifth of a sample of schizophrenics, over one-quarter of abstinent alcoholics, two-fifths of neurotics (including neurotic depressives) and almost half of senile dements. Abnormal DST was also found in 33 per cent of patients receiving prophylactic lithium for recurrent affective disorders.

Pre-Pubertal Depressive Stupor: A Case Report

1988 ◽  
Vol 153 (5) ◽  
pp. 689-692 ◽  
Author(s):  
J. C. Powell ◽  
W. R. Silveira ◽  
R. Lindsay
Keyword(s):  
Case Report ◽  
Family History ◽  
Affective Disorder ◽  
Dexamethasone Suppression Test ◽  
Clinical State ◽  
Affective Illness ◽  
History Of ◽  
Suppression Test ◽  
Dexamethasone Suppression ◽  
Maternal Side

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.

The dexamethasone suppression test in seasonal affective disorder

1986 ◽  
Vol 27 (3) ◽  
pp. 224-226 ◽  
Author(s):  
Steven P. James ◽  
Thomas A. Wehr ◽  
David A. Sack ◽  
Barbara L. Parry ◽  
Susan Rogers ◽  
...  
Keyword(s):  
Affective Disorder ◽  
Seasonal Affective Disorder ◽  
Dexamethasone Suppression Test ◽  
Suppression Test ◽  
Dexamethasone Suppression

Direct radioimmunoassay of cortisol in saliva and its application to the dexamethasone suppression test in affective disorders

1985 ◽  
Vol 10 (2) ◽  
pp. 193-201 ◽  
Author(s):  
Koichi Hanada ◽  
Naoto Yamada ◽  
Kazutaka Shimoda ◽  
Kiyohisa Takahashi ◽  
Saburo Takahashi
Keyword(s):  
Affective Disorders ◽  
Dexamethasone Suppression Test ◽  
Suppression Test ◽  
Dexamethasone Suppression

The Dexamethasone Suppression Test in Elderly, Non-Depressed Patients with Dementia

1985 ◽  
Vol 19 (1) ◽  
pp. 95-96 ◽  
Author(s):  
C. A. Galletly ◽  
H. Morris ◽  
A. Newcombe
Keyword(s):  
Depressive Disorder ◽  
Brain Damage ◽  
Dexamethasone Suppression Test ◽  
Clinical Criteria ◽  
Depressed Patients ◽  
Organic Brain ◽  
Suppression Test ◽  
Dexamethasone Suppression ◽  
Cerebral Disorder

Attempts have been made to use the dexamethasone suppression test (DST) to distinguish patients who have a primary depressive disorder from those suffering a degenerative cerebral disorder. It has been suggested however, that organic brain damage reduces neuroendocrine sensitivity and can be associated with failure to suppress on the DST. This study investigates the DST in 21 patients, over 65 years, with dementia but no evidence of depression on a variety of clinical criteria. Seven patients had abnormal DSTs.

Dexamethasone Suppression Test in Dementia and Depression

1989 ◽  
Vol 154 (3) ◽  
pp. 372-377 ◽  
Author(s):  
J. Shrimankar ◽  
Som D. Soni ◽  
J. McMurray
Keyword(s):  
The Elderly ◽  
Dexamethasone Suppression Test ◽  
Brain Disease ◽  
Clinical Assessments ◽  
Affective Symptoms ◽  
High Incidence ◽  
Organic Brain Disease ◽  
Organic Brain ◽  
Suppression Test ◽  
Dexamethasone Suppression

To determine the usefulness of the DST in differentiating depression from dementia, the test was administered to three diagnostic groups of psychogeriatric patients: depression; dementia; and dementia with depression. Clinical assessments were supplemented by ratings on the HRSD and SCAG, as well as by EEG and CT. All three groups showed a high incidence of abnormal DST results unrelated to presence or severity of affective symptoms, but showing a better association with SCAG and its ‘organic’ subsets. The mechanism(s) underlying these abnormal results may reflect organic brain disease. The usefulness of the DST in differentiating depression from dementia in the elderly was not confirmed.

The Dexamethasone Suppression Test in Affective Disorder

1982 ◽  
Vol 141 (5) ◽  
pp. 464-470 ◽  
Author(s):  
J. Mendlewicz ◽  
G. Charles ◽  
J. M. Franckson
Keyword(s):  
Affective Disorder ◽  
Menopausal Status ◽  
Early Morning ◽  
Dexamethasone Suppression Test ◽  
Psychotic Depression ◽  
Genetic Subgroup ◽  
Suppression Test ◽  
Severity Of Depression ◽  
Plasma Cortisol Suppression ◽  
Dexamethasone Suppression

SummaryPlasma Cortisol suppression after dexamethasone administration in 113 consecutively hospitalized patients (54 patients with primary depression, 41 with secondary depression and 18 non-depressed controls) showed early morning hypersecretion of Cortisol and Cortisol non-suppression after dexamethasone mainly in patients with primary depression. The sensitivity of the dexamethasone suppression test was 79 per cent in unipolar and bipolar primary depressed patients, specificity 79 per cent and diagnostic confidence of a positive test 82 per cent. Non-suppression to dexamethasone was observed in 81 per cent of patients with psychotic depression but only 37 per cent of those with non-psychotic depression. Age, sex and severity of depression, menopausal status, or benzodiazepines did not influence results. There was no association between Cortisol non-suppresssion and any genetic subgroup of affective disorder.

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