Am J Psychiatry 1988; 145:318-324
Copyright © 1988 by American Psychiatric Association
HPA axis abnormalities in depressed patients with normal response to the DST
W Meller, RG Kathol, RS Jaeckle, P Grambsch and JF Lopez
Department of Psychiatry, University of Iowa Hospitals, Iowa City 52242.
In order to identify depressed patients with hypothalamic-pituitary-
adrenal (HPA) axis abnormalities who have a normal response to the
dexamethasone suppression test (DST), the authors administered a series of
neuroendocrine tests including insulin-induced hypoglycemia, arginine
vasopressin challenge, and a DST. Using standard sensitivity measures, as
well as logistic regression, they concluded that many patients with HPA
abnormalities are not identified by the DST. These findings suggest that
other neuroendocrine tests, which are sensitive to HPA axis abnormalities,
may be helpful in subtyping depression on the basis of HPA axis
functioning.
