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Related Experiment Videos

The dexamethasone suppression test and suicidal patients.

J Ennis, R A Barnes, S Kennedy

The British Journal of Psychiatry : the Journal of Mental Science

|October 1, 1985

Summary

The dexamethasone suppression test (DST) is not a reliable indicator for identifying suicidal patients who may benefit from antidepressants in crisis units. Its poor specificity in this population can lead to misleading clinical decisions.

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Area of Science:

Psychiatry
Clinical Psychology
Neuroendocrinology

Background:

The dexamethasone suppression test (DST) has been investigated for its utility in diagnosing depression and predicting treatment response.
Its application in acute psychiatric settings, particularly for suicidal patients, requires further validation.

Purpose of the Study:

To evaluate the effectiveness of the DST in identifying suicidal patients in an in-patient crisis unit who might benefit from tricyclic antidepressants.
To assess the relationship between DST results, diagnostic criteria, and symptom severity in this specific patient group.

Main Methods:

The DST was administered to 72 patients admitted to an in-patient crisis unit.
Data collected included DST results, DSM-III diagnoses, and symptom level measurements.

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Patients were observed for a 3-5 day period.

Main Results:

Thirty-one patients were identified as non-suppressors.
Abnormal DST results did not correlate with DSM-III diagnoses or depression/symptom severity scores.
Only three patients met criteria for major depression with melancholia; a significant portion (26 patients) had alcohol or substance abuse diagnoses.

Conclusions:

The DST demonstrates poor specificity in an in-patient crisis unit population, particularly when substance abuse is prevalent.
Routine use of the DST in such settings may yield misleading results and is not recommended for identifying patients suitable for tricyclic antidepressants.