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Related Experiment Videos

Dexamethasone suppression testing of alcoholics

C M Swartz, F J Dunner

    Archives of General Psychiatry
    |November 1, 1982
    PubMed
    Summary

    Abnormal 4 pm cortisol levels after dexamethasone were common in men hospitalized for alcohol abuse. However, the 8 am cortisol level may be a more specific indicator for primary depressive illness in this population.

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    Area of Science:

    • Endocrinology
    • Psychiatry
    • Clinical Chemistry

    Background:

    • Alcohol abuse is frequently comorbid with depression.
    • The dexamethasone suppression test (DST) is used to screen for depression.
    • Cortisol dysregulation is observed in both alcohol use disorder and depression.

    Purpose of the Study:

    • To evaluate the utility of the DST in assessing primary depressive illness in recently abstinent male alcohol abusers.
    • To determine the specificity and potential diagnostic value of cortisol levels at different time points post-dexamethasone administration.

    Main Methods:

    • Forty-three hospitalized men with alcohol abuse were administered 1 mg of dexamethasone.
    • Serum cortisol levels were measured at 4 pm (17 hours post-dexamethasone) and 8 am (9 hours post-dexamethasone).
    • Patients were assessed for signs of alcoholic physical deterioration, depression symptoms, and family history of depression.

    Main Results:

    • Thirty-three percent (14/43) of patients exhibited abnormal 4 pm cortisol levels, indicating nonsuppression.
    • Most nonsuppressors showed signs of alcoholic physical deterioration, suggesting varied mechanisms for abnormal DST results.
    • Only 5% (2/43) of patients had abnormal 8 am cortisol levels.
    • Alcohol consumption, depression symptoms, and family history of depression were similar between suppressors and nonsuppressors.

    Conclusions:

    • The 4 pm cortisol level after dexamethasone is not specific enough to screen for primary depressive illness in recently abstinent alcohol abusers.
    • The 8 am cortisol level may hold potential utility as a screening tool for primary depressive illness in alcohol abusers without a family history of alcoholism.

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