The dexamethasone suppression test (DST) was administered to 120
adolescent psychiatric patients at the time of hospitalization, and
cortisol levels were measured at 4:00 p.m. and 11:30 p.m. on the day after
a 1-mg oral dose of dexamethasone was given. Failure to suppress serum
cortisol (i.e., cortisol level less than 5 micrograms/dl) was noted in 25
patients: 7 of 17 patients who met DSM-III criteria for major depressive
disorder, 7 of 38 patients with dysthymic disorder, 7 of 47 patients with
conduct disorder, and 4 of 15 schizophreniform patients. The predictive
value of the DST for major depressive disorder was only 28%. Although
adolescent patients with abnormal DSTs may eventually develop affective
symptoms consistent with a major depressive disorder, the DST did not
discriminate between major depression and other psychiatric diagnoses in
these hospitalized adolescents.Abstract Teaser