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July 1985

Postdexamethasone Cortisol Levels and Subgroups of Affective Illness

Author Affiliations

McLean Hospital Harvard Medical School Belmont, MA 02178

Arch Gen Psychiatry. 1985;42(7):739. doi:10.1001/archpsyc.1985.01790300107017

To the Editor.—  In their recent article on the use of biological markers in the assessment of patients with endogenous depression, Feinberg and Carroll1 found that unipolar depressed patients with endogenous depression had higher mean postdexamethasone cortisol values than their bipolar counterparts. In contrast, no differences were found in sleep studies between the two groups.Our group had previously reported differences on dexamethasone suppression test (DST) results between unipolar and bipolar depressed patients.2,3 It is thus gratifying to see a confirmation of our finding by these investigators. Prior to our reports,2,3 studies in the literature had generally failed to find significant differences between unipolar and bipolar patients in 4 PM postdexamethasone cortisol levels.4,5 Papakostas and associates6 found that 14 of 20 unipolar depressed patients were nonsuppressors, in contrast with zero of four bipolar depressed patients. In our study2 a higher percentage of unipolar (61%)