The dexamethasone suppression test in children and adolescents with major depressive disorder: a review

The authors review the available studies on the use of the dexamethasone suppression test (DST) in children and adolescents with psychiatric disorders. For the purposes of analysis, the authors divided the studies according to the two age groups. Pooled sensitivity, specificity, and positive predictive power were calculated for each age group per diagnostic category. DST nonsuppression among subjects with major depressive disorder (MDD) in the children's group was 69.6%, with a specificity of 69.7%, whereas for adolescent subjects, DST sensitivity was 41.3%, and specificity was 79.3%. The positive predictive power of an abnormal DST result in helping diagnose MDD in the children's group was 69.7%, whereas for the adolescent group, the positive predictive power was 66.6%. The authors conclude that the evidence cannot support the routine clinical use of the DST in children and in adolescents, but there may be a research role for the DST in these patient populations.