Abstract

BackgroundThe present study aimed to investigate the relationship between dexamethasone suppression test, personality disorder, stressful life events and depression.MaterialFifty patients (15 males and 35 females) aged 41.0 ± 11.4 years, suffering from Major Depression according to DSM-IV criteria entered the study.MethodDiagnosis was obtained with the aid of the SCAN v 2.0 and the IPDE. Psychometric assessment included the HDRS, HAS, the Newcastle Scale (version 1965 and 1971), the Diagnostic Melancholia Scale, the Personality Deviance Scale and the GAF scale. The 1 mg DST was used.Statistical AnalysisIncluded MANOVA, ANOVA with LSD post hoc test and chi-square test.ResultsSixteen (32%) patients were non-suppressors. Eight patients without Personality Disorder (PD) (23.5%), and 5 of those with PD of cluster B (50%) were non-suppressors. Atypical patients were the subtype with the highest rate of non-suppression (42.85%). No difference between suppressors and non-suppressors was detected in any of the scales.DiscussionThe results of the current study suggest that pathological DST is not a core feature of major depression. They also suggest that there are more than one subtypes of depression, concerning the response to stress. It seems that the majority of depressed patients (50%) does not experience high levels of stress either in terms of self reported experience or neuroendocrine function. The rest of patients however, either experience high levels of stress, or manifest its somatic analogue (DST non-suppression) or have a very low threshold of stress tolerance, which makes them to behave in a hostile way.

Highlights

  • The present study aimed to investigate the relationship between dexamethasone suppression test, personality disorder, stressful life events and depression.Material: Fifty patients (15 males and 35 females) aged 41.0 ± 11.4 years, suffering from Major Depression according to DSM-IV criteria entered the study

  • The present study aimed to investigate the relationship between dexamethasone suppression test, personality disorder (PD), stressful life events and clinical manifestations of major depression

  • The current study reports that personality disorders (PD) in depressed patients is 2.5–3 times higher in comparison to the general population

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Summary

Introduction

The present study aimed to investigate the relationship between dexamethasone suppression test, personality disorder, stressful life events and depression.Material: Fifty patients (15 males and 35 females) aged 41.0 ± 11.4 years, suffering from Major Depression according to DSM-IV criteria entered the study. The present study aimed to investigate the relationship between dexamethasone suppression test, personality disorder, stressful life events and depression. The Dexamethasone Suppression Test (DST) [5] is the most known and worldwide used biological marker, its results suggest that a disorder of the HPA axis is present in at least some depressed patients [6]. DST non-suppression is of unknown aetiology, and as a test is not specific to any disease. Rather it constitutes an endocrin expression of stress. DST is reported to assess norepinephrine function. It assesses the function of the hypothalamus and indirectly of the structures, which project to it. DST non-suppression and hypercortisolemia are two different things [8]

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