The dexamethasone suppression test in depression, in schizophrenia, and during experimental stress

Abstract

Early escape of plasma cortisol concentrations in the Dexamethasone Suppression Test (DST) has frequently been reported both in depressive illness (e.g., Carroll et al. 1981) and in other psychiatric diseases (e.g., Berger et al. 1982). However, no consensus has yet been reached on the etiology of DST nonsuppression (von Zerssen et al. 1984), or on its clinical relevance as a diagnostic marker for endogenous depression (Carroll et al. 1981) or as a predictor of clinical course, treatment outcome, and relapse in depressive illness (Coryell and Zimmermann 1983; Greden et al. 1983). The purpose of our study was to examine the effects of nonspecific stress factors on the DST. Nonspecific stress is well known to be one cause of excessive cortisol production (Selye 1971), and the DST is used to measure a special form of this excess. To our knowledge, this is the first study in which the DST was conducted in severely ill acute schizophrenics and in healthy volunteers during experimental stress.