우울증 환자에서의 약물치료에 따른 Dexamethasone 억제검사의 변화에 관한 연구

Dexamethasome Suppression Test in Drug Treatment of Depression

In this study the authors observed changes in response to the dexamethasone supprression test (DST) in depressed patients receiving antidepressants. Among 20 subjects. 15 were major depression and 5 were bipolar depression. The 8 of 20 subjects showed psychotic features, ar^ 12 of them did not show any psychotic features at all. All subjects underwent weekly DSTs with simultaneous clinical ratings (Hamilton Rating Scale for Depression-HRSD), both at the day of admission and during treatment. Dexamethasone (Decadron. lm g) was administered orally at 11 PM on the day of admission and every Wednesday during subsequent weeks. Blood samples for DST were collected at 4 PM and 11 PM on the second day of admission and every Thursday during subsequent weeks. The results of this study were as follows: 1) The 7 of 20 subjects (35%) were categorized as nonsuppressors and 13 (65%) were as suppres-scors. 2) There were no significant differences in age, sex, body weight, depressive subtype (unipolar v bipolar), length of admission, HRSD scores at admission and discharge, and clinical outcome between nonsuppressors and suppressors. 3) The results of DST were higher predictably among nonsuppressors than suppressors at the time of admission, but not significant difference at the time of discharge between these subgroups. 4) The results of DST were higher among subjects with psychotic features than subjects without psychotic features at the time of admission. However, there were no significant differences in DST results at the time of discharge and frequency of nonsuppressive response for DST between these subgroups. 5) There was significant correlation statistically between weekly post-DST cortisol levels in plasma and simultaneous HRSD scores among nonsuppressors, but no significant correlaton among suppressors