Am J Psychiatry 1984; 141:1577-1579
Copyright © 1984 by American Psychiatric Association
Differentiation of depression from chronic pain with the dexamethasone suppression test and DSM-III
RD France, KR Krishnan, JL Houpt and AA Maltbie
The concept of chronic pain has become enmeshed with depression. In an
attempt to unravel this complex relationship, the authors studied a uniform
group of 42 patients with chronic pain, i.e., patients who had chronic low
back pain with defined organic pathology, in relation to the dexamethasone
suppression test (DST). The results were analyzed in relation to the
presence or absence of major depression and cortisol suppression. Forty-one
percent of the patients with major depression had abnormal cortisol
responses to dexamethasone administration; all patients without major
depression had normal responses. These results suggest that chronic pain
patients differ from patients with major depression and a positive DST.
