A specific laboratory test for the diagnosis of melancholia. Standardization, validation, and clinical utility.
A specific laboratory test for the diagnosis of melancholia. Standardization, validation, and clinical utility.
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DOI：
10.1001/archpsyc.1981.01780260017001
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发表时间：
1981
影响因子：
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通讯作者：
B. Carroll;M. Feinberg;J. Greden;J. Tarika;A. Albala;R. Haskett;Norman McI. James;Z. Kronfol;N. Lohr;M. Steiner;Jean Paul de Vigne;E. Young
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文献类型：
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作者：
B. Carroll;M. Feinberg;J. Greden;J. Tarika;A. Albala;R. Haskett;Norman McI. James;Z. Kronfol;N. Lohr;M. Steiner;Jean Paul de Vigne;E. Young
438名受试者接受了地塞米松抑制试验（DST），以标准化诊断忧郁症（内源性抑郁症）的测试。地塞米松给药后24小时内血浆皮质醇浓度异常几乎只发生在抑郁症患者。血浆皮质醇的最佳标准浓度为5微克/分升，高于该浓度的DST结果可能被认为是异常。地塞米松的最佳剂量为1 mg，而不是2 mg。地塞米松给药后下午4点和11点采集的两份血液样本检测出98%的异常结果。该版本的DST识别忧郁症患者的敏感性为67%，特异性为96%。基线夜间血浆皮质醇浓度没有作用。抑郁症门诊患者与住院患者DST异常发生率相近；但它们与年龄、性别、最近使用精神药物或抑郁症状的严重程度无关。广泛的证据证实了这种诊断忧郁症的实用方法。
Four hundred thirty-eight subjects underwent an overnight dexamethasone suppression test (DST) to standardize the test for the diagnosis of melancholia (endogenous depression). Abnormal plasma cortisol concentrations within 24 hours after dexamethasone administration occurred almost exclusively in melancholic patients. The best plasma cortisol criterion concentration, above which a DST result may be considered abnormal, was 5 microgram/dL. The optimal dose of dexamethasone was 1 rather than 2 mg. Two blood samples obtained at 4 and 11 PM after dexamethasone administration detected 98% of the abnormal test results. This version of the DST identified melancholic patients with a sensitivity of 67% and a specificity of 96%. Baseline nocturnal plasma cortisol concentrations were not useful. Abnormal DST results were found with similar frequency among outpatients and inpatients with melancholia; but they were not related to age, sex, recent use of psychotropic drugs, or severity of depressive symptoms. Extensive evidence validates this practical test for the diagnosis of melancholia.