39 adults (19 major depressive inpatients and 20 normal controls) underwent the dexamethasone suppression test (DST) and serum cortisol concentrations at 8 : 00, 16 : 00 and 23 : 30 hour were determined in duplicate by radioimmunoassay technique. Utilizing the above previously published data, CSI (the ratio of predexamethasone cortisol concentration divided by the postdexamethasone corti- sol concentration determined at the same time of the day) at 8 : 00, 16 : 00 and 23 : 30 hour were calculated and comparisons were made between the CSI results and the already available DST results. The results and the conclusions are as follows: 1. Statistically significant difference of the CSI results was noted at 8 : 00 and 16 I 00 hour between the major depressives and the normal controls (Student’s t-test, two-tailed, p < 0 .05). 2. The CSI at 16 􀆮 00 hour proved to be superior to the DST result in sensitivity, specificity, and predictive value(47%, 90% & 82% vs. 42%, 80% & 67%). The cortisol suppression index at 16 : 00 hour may serve as a valid and convenient tool for dia- gnosing patients with major depression.
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