The Role of Stress in Interpreting the Dexamethasone Suppression Test

1992 ◽  
Vol 37 (10) ◽  
pp. 724-727 ◽  
Author(s):  
Jane Blouin ◽  
Eric Spindler ◽  
Edgardo Perez ◽  
Arthur Blouin ◽  
Steven Hotz ◽  
...  
Keyword(s):  
Environmental Stress ◽  
Psychological Assessment ◽  
Confounding Factor ◽  
Dexamethasone Suppression Test ◽  
Blood Tests ◽  
Routine Administration ◽  
Suppression Test ◽  
Cortisol Suppression ◽  
Dexamethasone Suppression

Stress has been implicated as a major confounding factor in the interpretation of Dexamethasone Suppression Test (DST) results. This study was designed to examine the effects of stress on DST results. Fifty patients with high levels of acute, chronic, and environmental stress participated in the study. Each patient was given a comprehensive psychiatric and psychological assessment, a routine administration of dexamethasone, and blood tests of cortisol values. The results indicate that the three measures of stress do not appear to affect levels of cortisol suppression, however, all three measures of stress predicted depression. As expected, DST cortisol levels were related to depression. Results are discussed in terms of their implications for understanding the associations among stress, depression and DST results.

Sleep, dexamethasone suppression test, and response to somatic therapies in an atypical affective state presenting as erotomania: a case report

1991 ◽  
Vol 6 (5) ◽  
pp. 269-271
Author(s):  
L Staner
Keyword(s):  
Case Report ◽  
Affective State ◽  
Dexamethasone Suppression Test ◽  
Depressive State ◽  
Suppression Test ◽  
Somatic Therapies ◽  
Dexamethasone Suppression

SummaryThe case of a woman presenting erotomania in the course of a loss-related depressive state is described. Clinical, biological and therapeutical characteristics highlight the role of mood in certain cases of erotomania and add support to previous accounts of the heterogeneity of this syndrome.

Cortisol Suppression Index in Major Depressive Illness

1984 ◽  
Vol 18 (3) ◽  
pp. 277-279 ◽  
Author(s):  
Allen Fraser
Keyword(s):  
Depressive Illness ◽  
Dexamethasone Suppression Test ◽  
Diagnostic Confidence ◽  
Major Depressive ◽  
Acceptable Alternative ◽  
Late Evening ◽  
Suppression Test ◽  
Cortisol Suppression ◽  
Dexamethasone Suppression ◽  
Suppression Index

This study compares the utility of a cortisol suppression index with the standard dexamethasone suppression test as a diagnostic aid for major depressive disorder. In 50 patients the cortisol suppression index was found to have similar sensitivity while also having greater specificity and diagnostic confidence than the dexamethasone suppression test. By avoiding the need for a late-evening blood sample, the cortisol suppression index may be an acceptable alternative to the current procedure.

The Role of Cortisol/ACTH Ratio for Screening of Subclinical Hypercortisolism in Patients with Adrenal Incidentalomas

2017 ◽  
Vol 126 (02) ◽  
pp. 71-76
Author(s):  
Lele Li ◽  
Guoqing Yang ◽  
Jingtao Dou ◽  
Weijun Gu ◽  
Zhaohui Lv ◽  
...  
Keyword(s):  
Area Under The Curve ◽  
Adrenal Incidentaloma ◽  
Serum Cortisol ◽  
Dexamethasone Suppression Test ◽  
Subclinical Hypercortisolism ◽  
Reliable Parameter ◽  
Suppression Test ◽  
Cortisol Levels ◽  
Dexamethasone Suppression

Abstract Introduction The cortisol/ACTH ratio was supposed to be helpful in the screening of subclinical hypercortisolism (SHC) in the published literatures. This study assessed the cortisol/ACTH ratio in patients with adrenal incidentaloma (AI) confirmed to have SHC and investigated its role for screening SCS in patients with AI. Methods This descriptive retrospective study included 183 patients with AIs [45 with SHC and 138 with non-functional adenoma (NFA)]. Cortisol and ACTH levels were measured at 8:00, 16:00, and 0:00, and the cortisol/ACTH ratio was calculated. ROC curve was used to evaluate efficacy of the cortisol/ACTH ratio, explore the best cut-off value and its corresponding sensitivity and specificity. Results The cortisol/ACTH ratios at all time points were significantly higher in the SHC group than the NFA group (P<0.05) and were significantly correlated with serum cortisol levels after the 1-mg dexamethasone suppression test (DST). Area Under the Curve (AUC) of the cortisol/ACTH ratio at 0:00 and midnight serum cortisol levels were 0.893 (0.843–0.943) and 0.831 (0.765–0.806), respectively. A cortisol/ACTH ratio at 0:00 cut-off of 32.18 nM/pM showed a sensitivity of 100% and specificity of 39.1%. The optimal cut-off was 68.83 nM/pM (sensitivity 86.7%, specificity 75.4%). Conclusions Patients with SHC have a higher cortisol/ACTH ratio than those with NFAs. The cortisol/ACTH ratio is significantly correlated with serum cortisol after the 1-mg DST. The diagnostic performance of the cortisol/ACTH ratio at 0:00 is superior to midnight serum cortisol. Therefore, the cortisol/ACTH ratio at 0:00 may be a reliable parameter for SHC screening in patient with AI.

Findings with 0.25 mg Dexamethasone Suppression Test in Eating Disorders: Association with Childhood Trauma

CNS Spectrums ◽  
2007 ◽  
Vol 12 (9) ◽  
pp. 675-680 ◽  
Author(s):  
Marina Díaz-Marsá ◽  
José L. Carrasco ◽  
Elena Basurte ◽  
José I. Pastrana ◽  
Jerónimo Sáiz-Ruiz ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Childhood Trauma ◽  
Dexamethasone Suppression Test ◽  
Hypothalamic Pituitary Adrenal Axis ◽  
Hypothalamic Pituitary Adrenal ◽  
Adrenal Axis ◽  
Suppression Test ◽  
Cortisol Suppression ◽  
Dexamethasone Suppression ◽  
Pituitary Adrenal Axis

ABSTRACTIntroduction: While both blunted and enhanced cortisol suppression following a dexamethasone suppression test (DST) are described in eating disorders, some evidence suggests that enhanced cortisol suppression might be associated with the presence of trauma history. The objective of this study is to investigate hypothalamic-pituitary-adrenal axis response to a modified DST in eating disorders and its relationship with childhood trauma.Methods: Fifty-two patients with eating disorders were studied with a 0.25 mg DST and with measures of childhood trauma.Conclusion: Patients with bulimia symptoms had significantly greater cortisol suppression than controls and restrictive anorexia patients (F=8.2, P<.05). Cortisol suppression was significantly correlated with intensity of childhood traumatic events (F=0.32, P<.05). Hypersensitive hypothalamic-pituitary-adrenal axis response to DST in eating disorders may be related with a history of childhood trauma and suggests some biological similarities with posttraumatic syndromes that should be further explored.

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