우울증과 정신분열증 환자들에서 Dexamethasone 투여투 혈청 Cortisol 값과 우울증상

Postdexamethasone Cortisol Levels and Depressive Symptoms in Depression and Schizophrenic Patients

To understand the relationship between DST and depressive symptoms in depression and schizophrenia, 28 depression patients and 30 schizophrenic patients underwent DST during their hospitalization along with HRSD and BDI to assess depressive symptoms. The mean postdexamethasone cortisol levels were 4.74+5.87 (ig/dl in depression group and 4.39+4.09 (ig/dl in schizophrenic group. DST nonsuppression being defined as postdexamethasone cortisol level above 5 |ig/dl, 9 of 28 depression patients (30.2 % ) and 9 of 30 schizophrenic patients (30%) were nonsuppressors. In depression group, DST nonsuppressors had significantly severe depressive symptoms in HRSD and BDI. Among individual symptoms, depressed mood, retardation and lack of insight of HRSD, and sadness, sense of failure, irritability, indecisiveness, work difficulty and fatigability of BDI were higher in DST nonsuppressors. In schizophrenic group, there was no difference in the severity of depression between nonsuppressors and suppressors, but psychic anxiety and somatic anxiety of HRSD were higher in nonsuppressors. There were significant positive correlations between the severity of depression and postdexamethasone cortisol levels in depression group, but not in schizophrenic gruop. Those symptoms that had positive correlations with postdexamethasone cortisol levels were retarded depressive symptoms in depression group and anxiety symptoms in schizophrenic group. This results partially support the hypothesis that, while DST nonsuppression might be a specific biological reaction in depressive disorder, it is a nonspecitfic reaction to stress in schizophrenia.