Am J Psychiatry 1984; 141:1220-1223
Copyright © 1984 by American Psychiatric Association
Validation of four definitions of melancholia by the dexamethasone suppression test
J Davidson, S Lipper, WW Zung, R Strickland, R Krishnan and S Mahorney
The authors evaluated four sets of diagnostic criteria, the Newcastle
Index, DSM-III, RDC, and the Michigan Diagnostic Index, for the diagnosis
of melancholia. Forty-nine depressed inpatients, all of whom met RDC for
major depression, also received consensus diagnostic assessment for
melancholia. The dexamethasone suppression test (DST) was administered
before drug treatment began. Results showed that the sensitivity of the DST
ranged from 39% to 48%, specificity from 80% to 100%, and diagnostic
confidence from 66% to 100%. All four scales received validation, but
DSM-III showed the lowest specificity and predictive value.
