Am J Psychiatry 1989; 146:473-477
Copyright © 1989 by American Psychiatric Association
HPA axis hyperactivity and recovery from functional psychoses
WH Coryell and M Zimmerman
Department of Psychiatry, University of Iowa, Iowa City 52242.
Some patients with functional psychoses follow a chronic, deteriorating
course and others recover; at present clinicians have essentially no
established factors beyond diagnosis and chronicity to predict which course
a psychotic patient might follow. Because data on diagnostic specificity
suggested that the dexamethasone suppression test might provide another,
much needed prognostic factor, the authors administered these tests to 98
consecutively admitted patients with nonmanic psychoses. High
postdexamethasone cortisol levels (6 micrograms/dl or higher) at baseline
predicted recovery from psychosis at 1 year, independent of episode
chronicity and diagnosis. Diagnosis did not correspond well to test results
but was itself an important predictor.
