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Article
May 1985

A Sensitive, Outpatient Dexamethasone Suppression Test

Author Affiliations

Civil Hospital, Department of Psychiatry 45 rue Destree B6000 Charleroi, Belgium
University of Texas Health Sciences Center Department of Psychiatry Affective Disorders Unit 5323 Harry Hines Blvd Dallas, TX 75235

Arch Gen Psychiatry. 1985;42(5):523-524. doi:10.1001/archpsyc.1985.01790280105013
Abstract

To the Editor.—  Dr Sherman and colleagues1 noted how study design may affect results with the dexamethasone suppression test (DST) in depression. Their observations may explain the 35% to 60% sensitivity in endogenously depressed patients.2 Perhaps every endogenously depressed patient (or even each patient in a larger diagnostic group) is a nonsuppressor, but because of the episodic hormone release we can detect cortisol escape only one time out of two in a single blood sample. One clinical advantage of the DST is its ease of use in outpatients. Blood sampled every 20 minutes is more likely to demonstrate early escape than a single sample and multiple samples have been proposed to increase the sensitivity of the DST.2,3 However, in outpatients, it is difficult to draw blood samples at 4 and 11 PM.

Patients and Methods.—  We have been investigating a more sensitive DST method that is feasible

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