Agoraphobia and the Dexamethasone Suppression Test: Atypical Depression?

1984 ◽  
Vol 18 (4) ◽  
pp. 374-377 ◽  
Author(s):  
H. A. Whiteford ◽  
Larry Evans
Keyword(s):  
Tricyclic Antidepressants ◽  
Biological Marker ◽  
Dexamethasone Suppression Test ◽  
Panic Attacks ◽  
Control Group ◽  
Atypical Depression ◽  
Panic Disorders ◽  
State Dependent ◽  
Suppression Test ◽  
Dexamethasone Suppression

The tricyclic antidepressants and the monoamine oxidase inhibitors have been shown to be effective in the treatment of some patients with phobic and panic disorders. To explain this action it has been suggested that a number of these patients may have an atypical biological depression. In an attempt to test this hypothesis we used the dexamethasone suppression test (DST), which has been proposed as a state dependent biological marker of depression. We compared the non-suppression rate of agoraphobic patients suffering panic attacks with controls and with patients suffering major depression. Twenty-nine per cent of the agoraphobics showed non-suppression compared with 12% of the control group and 64% of the depressives.

scholarly journals Hypothalamic-pituitary-adrenal axis response in borderline personality disorder without post-traumatic features

2007 ◽  
Vol 190 (4) ◽  
pp. 357-358 ◽  
Author(s):  
Jose L. Carrasco ◽  
Marina Díaz-Marsá ◽  
Jose I. Pastrana ◽  
Rosa Molina ◽  
Loreto Brotons ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Feedback Inhibition ◽  
Borderline Personality ◽  
Dexamethasone Suppression Test ◽  
Control Group ◽  
Hypothalamic Pituitary Adrenal ◽  
Suppression Test ◽  
Post Traumatic ◽  
Dexamethasone Suppression

SummaryHypothalamic–pituitary–adrenal (HPA) axis sensitivity was investigated in 32 non-medicated patients with borderline personality disorder without comorbid post-traumatic syndromes and in 18 normal individuals using a modified dexamethasone suppression test (0.25 mg). Enhanced cortisol suppression was found in the patients v. controls (P < 0.05) and the percentage of participant's with non-suppression was smaller in the patient (34%) than in the control group (89%) (P < 0.01). Baseline cortisol levels in the patients were also lower than in the controls (P < 0.05). The 0.25 mg dexamethasone suppression test reveals increased feedback inhibition of the HPA in borderline personality disorder.

The Dexamethasone Suppression Test and Suicidal Patients

1985 ◽  
Vol 147 (4) ◽  
pp. 419-423 ◽  
Author(s):  
Jon Ennis ◽  
Rosemary A. Barnes ◽  
Sidney Kennedy
Keyword(s):  
Substance Abuse ◽  
Major Depression ◽  
Patient Population ◽  
Tricyclic Antidepressants ◽  
Dexamethasone Suppression Test ◽  
The Poor ◽  
Suppression Test ◽  
Suicidal Patients ◽  
Dexamethasone Suppression

The dexamethasone suppression test (DST) was used in an in-patient crisis unit to determine whether the test could identify suicidal patients who might benefit from tricyclic antidepressants. DST results, DSM-III diagnoses, and measures of symptom levels were obtained for 72 patients admitted for a 3–5 day period; 31 were non-suppressors. Abnormal DST results were not related to DSM-III diagnosis or to scores on measures of depression and symptom levels. Only three patients met DSM-III criteria for major depression with melancholia; 26 patients had a diagnosis of alcohol or substance abuse. The poor specificity of the DST in this patient population suggests that its routine use in such patients could be highly misleading.

Dexamethasone Suppression Test in Predicting Response to Tricyclic Antidepressants in Depressed Outpatients

1985 ◽  
Vol 18 (4) ◽  
pp. 206-211 ◽  
Author(s):  
Eric D. Peselow ◽  
Ngaere Goldring ◽  
Faouzia Barouche ◽  
Ronald R. Fieve
Keyword(s):  
Tricyclic Antidepressants ◽  
Dexamethasone Suppression Test ◽  
Suppression Test ◽  
Dexamethasone Suppression

Defining Melancholia: Properties of a Refined Sign-Based Measure

1994 ◽  
Vol 164 (3) ◽  
pp. 316-326 ◽  
Author(s):  
Gordon Parker ◽  
Dusan Hadzi-Pavlovic ◽  
Kay Wilhelm ◽  
Ian Hickie ◽  
Henry Brodaty ◽  
...  
Keyword(s):  
Reaction Time ◽  
Treatment Response ◽  
Biological Marker ◽  
Dexamethasone Suppression Test ◽  
Melancholic Depression ◽  
Independent Measure ◽  
Depressed Patients ◽  
Suppression Test ◽  
Dexamethasone Suppression ◽  
Response Variables

We hypothesised that psychomotor disturbance is specific to the melancholic subtype of depression and capable of defining melancholia more precisely than symptom-based criteria sets. We studied 413 depressed patients, and examined the utility of a refined, operationally driven set of clinician-rated signs, principally against a set of historically accepted symptoms of endogeneity. We specified items defining psychomotor disturbance generally as well as those weighted either to agitation or to retardation. We demonstrated the system's capacity to differentiate ‘melancholic’ and ‘non-melancholic’ depression (and the comparable success of DSM–III–R and Newcastle criteria systems) by reference to several patient, illness and treatment response variables, to an independent measure of psychomotor disturbance (reaction time) and to a biological marker (the dexamethasone suppression test).

scholarly journals The dexamethasone suppression test in inpatients with panic disorder or agoraphobia with panic attacks

1987 ◽  
Vol 22 (4) ◽  
pp. 517-521 ◽  
Author(s):  
Leon Grunhaus ◽  
Dolores Tiongco ◽  
Roger F. Haskett ◽  
John F. Greden
Keyword(s):  
Panic Disorder ◽  
Dexamethasone Suppression Test ◽  
Panic Attacks ◽  
Suppression Test ◽  
Dexamethasone Suppression

Platelet serotonin-binding and dexamethasone suppression test in melancholia and dysthymia

1994 ◽  
Vol 9 (6) ◽  
pp. 281-287 ◽  
Author(s):  
C Gastó ◽  
J Vallejo ◽  
JM Menchón ◽  
R Catalán ◽  
A Otero ◽  
...  
Keyword(s):  
Major Depression ◽  
Normal Subjects ◽  
Dexamethasone Suppression Test ◽  
Dysthymic Disorder ◽  
Control Group ◽  
Platelet Serotonin ◽  
Significant Difference ◽  
Suppression Test ◽  
Dexamethasone Suppression

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.

Retrospective analysis of repeated dexamethasone suppression tests – the added value of measuring dexamethasone

2019 ◽  
Vol 56 (6) ◽  
pp. 708-710 ◽  
Author(s):  
Albert J de Graaf ◽  
AH Leontine Mulder ◽  
Johannes G Krabbe
Keyword(s):  
Serum Cortisol ◽  
Dexamethasone Suppression Test ◽  
Added Value ◽  
Control Group ◽  
Suppression Test ◽  
Dexamethasone Suppression ◽  
Positive Results ◽  
Test Serum ◽  
Selection Of Patients ◽  
Selection Of

Background In the evaluation for hypercortisolism (Cushing’s syndrome), the 1 mg overnight dexamethasone suppression test has an important role, but false-positive results can occur due to low serum dexamethasone. Given the high intraindividual reproducibility of post-dexamethasone suppression test serum cortisol concentrations, we investigated the chance of success of repeating a non-suppressed dexamethasone suppression test if serum dexamethasone is low. Methods We retrospectively analysed the results of 1901 consecutive dexamethasone suppression tests performed in our laboratory from February 2011 to November 2018. Serum dexamethasone and cortisol were measured by LC-MS/MS, and both were reported. The 2.5 and 5th percentiles of serum dexamethasone in suppressed dexamethasone suppression tests were investigated as cut-off value. Then, we retrospectively determined the success rate of repeating an initial, non-suppressed dexamethasone suppression test in 131 patients, stratified by initial serum dexamethasone. Results At serum dexamethasone concentrations between the 2.5 and 5th percentiles (3.2–3.9 nmol/L), significantly more non-suppressed dexamethasone suppression tests were observed (27/67) than in the control group of 1357 tests having serum dexamethasone ⩾6 nmol/L (40% vs. 30%, P = 0.047), indicating that 3.9 nmol/L is the better cut-off. Overall, 40% of non-suppressed dexamethasone suppression tests were repeated, but repeat testing was performed more often when serum dexamethasone was low. In patients who had initial serum dexamethasone below the cut-off of 3.9 nmol/L, a significantly higher chance of having a suppressed repeat dexamethasone suppression test was observed compared to the control group: 57% (31/54) vs. 26% (15/57), P = 0.001. Conclusions Measuring and reporting serum dexamethasone in dexamethasone suppression tests have added value for the selection of patients who might benefit from a repeat dexamethasone suppression test. We suggest a cut-off for serum dexamethasone of ⩾3.9 nmol/L.

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