To the Editor.—
Nonsuppression of plasma cortisol in the dexamethasone suppression test (DST) is regarded as a highly specific marker for endogenous depression.1,2 Weight loss in anorexia nervosa and in patients with severe protein-caloric malnutrition also causes DST nonsuppression.3-5 Diminished appetite with resulting low caloric intake and weight loss is one of the most prominent symptoms of depressive illness.6 Therefore, it is worthwhile to consider how far weight loss may be responsible for DST nonsuppression in depressed patients. In a study with 20 endogenous, 19 neurotic, and six unclassified depressed patients with a comparable degree of severity of depression, the 1.5-mg DST was performed.7 Blood samples were taken at 9 AM and 4 PM after dexamethasone had been given orally at 11 PM.The DST results were abnormal (at least one cortisol value >5ug/dL) in five endogenous (25%) and four neurotic (21.1%) depressives, but in none
Berger M, Pirke K, Doerr P, Krieg C, Von Zerssen D. Influence of Weight Loss on the Dexamethasone Suppression Test. Arch Gen Psychiatry. 1983;40(5):585–586. doi:10.1001/archpsyc.1983.01790050111015
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