Endocrine responses after thyrotrophin-releasing hormone stimulation and dexamethasone suppression tests in the major...

The effects of dexamethasone 1 mg on plasma cortisol levels and of thyrotrophin-releasing hormone (TRH) 200 micrograms on thyrotrophin (TSH), growth hormone and prolactin levels in 107 patients with a major depressive disorder (MDD) were compared with those in 87 healthy subjects. Individual hormonal responses and combinations of hormonal responses after administration of dexamethasone and TRH were evaluated as diagnostic aids for MDD by calculating sensitivity, specificity and efficiency for single and multiple hormonal abnormalities. In patients suffering from MDD, 65% of men, 74% of reproductive women and 71% of menopausal or hysterectomized (H/M) women had abnormal responses (sensitivity) to a dexamethasone suppression test (DST). When the DST and TSH responses to TRH were combined, 85% of men, 87% of reproductive women and 84% of H/M women had abnormal results. If the efficiency of the different combinations of hormone responses is calculated, a totally different picture emerges.