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February 1985

Limited Utility of the 1-mg Dexamethasone Suppression Test as a Measure of Hypercortisolism

Author Affiliations

University of Iowa Department of Psychiatry Iowa City, IA 52242

Arch Gen Psychiatry. 1985;42(2):200-201. doi:10.1001/archpsyc.1985.01790250094012

To the Editor.—  In their multicenter investigation of the dexamethasone suppression test (DST), Stokes et al1 found that nonsuppression (NS) was more frequent among healthy normal persons than has previously been reported, and that, among depressed patients, abnormal DST results were not significantly more frequent in endogenous, melancholic, or psychotic subtypes.In placing their results in the context of the DST literature, Stokes et al reviewed only three other studies of the DST in healthy control subjects.2-4 They attributed the low nonsuppression rates found by Carroll et al2 and McHardy-Young et al3 to the fact that these investigators used 2 mg of dexamethasone. In contrast, Amsterdam et al4 used only 1 mg of dexamethasone and found a relatively high nonsuppression rate in healthy control subjects, similar to data obtained by Stokes et al.1 Based on their own study and their limited literature review, Stokes et

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