우울증에 있어 Dexamethasone 억제검사의 판정기준 및 그 양성반응과 임상증상들 간의 관련성

Diagnostic Significance of Various Cut-Off Points of Post-Dexamethasone Cortisol Level and the Relation Between the Positive Finding and Clinical Symptoms

To evaluate the diagnostic significance of various cut-off points of post-dexamethasone cortisol level and the relation between the positive finding of the dexamethasone suppression test (DST) and clinical symptoms, DST was performed in 22 patients with major depression and 25 patients with other psychiatric disorders. The diagnostic criteria of DSM-III were used. The clinical symptoms of the patients were rated with the Hamilton Rating Scale for Depression ( HDS) and the Brief Psychiatric Rating Scale (BPRS). The results showed that, among various cutoff points of post-dexamethasone cortisol levels, 5.0ug/dl seemed to be the most appropriate level for judgement criteria, considering sensitivity, specificity and diagnostic confidence. The total scores of HDS in all patients with positive DST were significantly higher than those with negative DST. However, the total scores of BPRS were not significantly different between the two groups. The scores of items of depression and somatic symptoms in HDS and BPRS were significantly higher in patients with positive DST. In the major depression group, the total scores of HDS and BPRS in patients with positive DST were not significantly different from those in patients with negative DST. Among all of the subscales of HDS and BPRS, only the scores of anxiety somatic and general somatic symptoms were significantly higher in patients with positive DST than in those with negative DST.