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Related Experiment Videos

Cortisol secretion and dexamethasone response in depression

G M Asnis, E J Sachar, U Halbreich

    The American Journal of Psychiatry
    |September 1, 1981
    PubMed
    Summary

    The dexamethasone suppression test can indicate abnormal cortisol hypersecretion in depression. While specific, this test is not highly sensitive for detecting elevated cortisol levels in depressed patients.

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    Area of Science:

    • Endocrinology
    • Psychiatry
    • Neuroscience

    Background:

    • Depression is often associated with dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis.
    • Elevated cortisol levels are a common finding in patients with major depressive disorder.
    • The dexamethasone suppression test (DST) is used to assess HPA axis function.

    Purpose of the Study:

    • To evaluate the utility of the 2-mg dexamethasone suppression test in identifying cortisol hypersecretion in patients with endogenous depression.
    • To determine the sensitivity and specificity of the DST for detecting abnormalities in 24-hour cortisol secretion.

    Main Methods:

    • Administered 2 mg of dexamethasone at 11:00 p.m. to 37 unmedicated, hospitalized, endogenously depressed patients.
    • Assessed plasma cortisol response at 4:00 p.m. and 11:00 p.m. the following day.

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  • Measured mean 24-hour plasma cortisol concentration in a subset of patients (n=26) and single time-point samples in others (n=32).

    • Main Results:

    • Mean 24-hour plasma cortisol concentration was elevated in 50% of patients.
    • Only 7 out of 26 patients exhibited dexamethasone resistance.
    • Of the 7 dexamethasone-resistant patients, 6 were identified as hypersecretors of cortisol.

    Conclusions:

    • Dexamethasone resistance may reflect an abnormality in cortisol hypersecretion characteristic of depression.
    • The 2-mg dexamethasone suppression test demonstrates high specificity but limited sensitivity for detecting cortisol hypersecretion in depression.