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May 1983

Accuracy of Dexamethasone Suppression Test in Alcoholics

Author Affiliations

The University of Michigan Psychiatric Hospitals (Box 11) Ann Arbor, MI 48109

Arch Gen Psychiatry. 1983;40(5):586. doi:10.1001/archpsyc.1983.01790050112016

To the Editor.—  The report by Swartz and Dunner in the November issue (Archives 1982;39:1309-1312) confirms the need for careful screening of patients by clinicians who wish to use the dexamethasone suppression test (DST) as a laboratory aid in the diagnosis of melancholia.1-3 Swartz and Dunner provide a second data base on the interference of alcoholism with the DST, first described by Oxenkrug.4 Their report serves to emphasize the caution necessary when dealing with this problem, as we stated in our report on the standardization of the DST.1Swartz and Dunner failed to acknowledge that we listed acute withdrawal from alcohol as one of the medical exclusion criteria for the DST.1 They also wrongly implied that we reported normal DST results in alcoholics. They stated: "In some reports... all alcoholic patients showed normal results." An attentive reading of our report will reveal that no alcoholics were