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Research Article| Volume 22, ISSUE 7, P883-891, July 1987

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Dexamethasone suppression test and urinary MHPG · SO4 determination in depressive disorders

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      Abstract

      The Dexamethasone Suppression Test (DST) was performed in 64 depressed inpatients, in 48 schizophrenics, and in 20 normal controls. Thirty-four percent of depressive inpatients were found to escape from dexamethasone suppression significantly higher than either schizophrenics (13%) or normal subjects (5%). Among subgroups, bipolar and unipolar endogenous depression patients had much higher abnormal rates for the DST (59% and 48%, respectively) than nonendogenous cases (8%). DST results were also found to be positively correlated with patients' Hamilton scores. These findings suggested that DST could be helpful in diagnosis, discrimination of subtypes, and in assessment of severity of symptoms. In 32 of the 64 depressed inpatients, urinary MHPG · SO4 excretion was determined and compared with 21 normal controls. Bipolar patients (n = 7) had less MHPG · SO4 excretion than unipolar endogenous patients (n = 16). Excretion was positively correlated with cortisol level at 17 hr after dexamethasone administration in 32 depressive inpatients, especially in the unipolar subgroup. A trend toward negative correlation, though not statistically significant, was found in bipolar depression between cortisol levels at 17 hr after dexamethasone administration and urinary MHPG · SO4 excretion. This may indicate that some differences in norepinephrine (NE) metabolism may exist between unipolar and bipolar depression, leading to differing correlations between deviation of central NE function and hypothalamus-pituitary-adrenal (HPA) axis in different subgroups of depression.
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      References

        • Alexopulos GS
        • Young RC
        • Haycox JA
        • Shamoian CA
        • Blass JP
        DST in geriatric depression and dementia.
        in: New Research Abstracts, American Psychiatric Association 137th Annual Meeting, no. 32. 1984
        • Amsterdam JD
        • Winokur A
        • Lucki I
        • Caroff S
        • Snyder P
        • Rickeis K
        A neuroendocrine test battery in bipolar patients and healthy subjects.
        Arch Gen Psychiatry. 1983; 40: 515-521
        • Baldessarini RJ
        • Arana GW
        Does the Dexamethasone Suppression Test have clinical utility in psychiatry?.
        Clin Psychiatry. 1985; 46: 25-29
        • Belmaker RH
        • Bracha HS
        • Ebstein RP
        Platelet monoamine oxidase in affective illness and alcoholism.
        Schizophr Bull. 1980; 6: 320-323
        • Brown WA
        • Johnston R
        • Mayfield D
        The 24 hour Dexamethasone Suppression Test in a clinical setting: Relationship to diagnosis, symptoms and response to treatment.
        Am J Psychiatry. 1979; 136: 545
        • Brown WA
        • Keitner G
        • Quails CB
        • Haier R
        The Dexamethasone Suppression Test and pituitary-adrenocortical function.
        Arch Gen Psychiatry. 1985; 42: 121-123
        • Carroll BJ
        Dexamethasone Suppression Test for depression.
        in: Usdin E Frontiers in Biochemical and Pharmacological Research in Depression. Raven Press, New York1984: 179-188
        • Carroll BJ
        Dexamethasone Suppression Test: A review of contemporary confusion.
        Clin Psychiatry. 1985; 46: 9-12
        • Carroll BJ
        • Feinberg BJ
        • Feinberg M
        • Greden JF
        • Tarika J
        • Albala AA
        • Haskett RF
        • James NM
        • Kronfok Z
        • Lohr N
        • Steiner M
        • deVigne JP
        • Young E
        A specific laboratory test for the diagnosis of melancholia.
        Arch Gen Psychiatry. 1981; 38: 15-22
        • Chen Z
        • Fan Z
        Radioimmunoassay of human plasma cortisol.
        Research of tumour prevention and treatment. 1975; 4 (in Chinese).: 14-19
        • Coppen A
        • Ghose K
        Peripheral adrenoreceptor and central dopamine receptor activity in depressive patients.
        Psychopharmacology. 1978; 59: 171-177
        • Dunner DL
        • Gershon ES
        • Goodwin FK
        Heritable factors in the severity of affective illness.
        Biol Psychiatry. 1976; 11: 31-42
        • Edelstein CK
        • Roy-Byrne P
        • Fawzy FI
        • Dornfeld L
        Effects of weight loss on the Dexamethasone Suppression Test.
        Am J Psychiatry. 1983; 140: 338-341
        • Edwards DJ
        • Spiker DG
        • Neil JF
        • Kupfer DJ
        • Rizk M
        MHPG excretion in depression.
        Psychiatry Res. 1980; 2: 295-305
        • Evans DL
        • Burnett GB
        • Nemeroff CB
        The Dexamethasone Suppression Test in the clinical setting.
        Am J Psychiatry. 1983; 140: 586-589
        • Evans DL
        • Nemeroff CB
        The Dexamethasone Suppression Test in mixed bipolar disorder.
        Am J Psychiatry. 1983; 140: 615-617
        • Fraser AR
        Choice of antidepressant based on the Dexamethasone Suppression Test.
        Am J Psychiatry. 1983; 140: 786-787
        • Goldberg JK
        Dexamethasone Suppression Tests in depression and response to treatment.
        Lancet. 1980; ii: 92
        • Greden JF
        • Albala AA
        • Haskett RF
        • James NM
        • Goodman L
        • Steiner M
        • Carroll BJ
        Normalization of Dexamethasone Suppression Test (DST): A laboratory index of recovery from endogenous depression.
        Biol Psychiatry. 1980; 15: 449-458
        • Greden JF
        • Gardner R
        • King D
        • Grunhaus L
        • Carroll BJ
        • Kronfol Z
        Dexamethasone Suppression Test in antidepressant treatment of melancholia.
        Arch Gen Psychiatry. 1983; 40: 493-500
        • Gwirtsman HE
        • Gerner RE
        • Sternbach HA
        Abnormalities in anorexia nervosa of Dexamethasone Suppression Test and urinary MHPG suggest a norepinephrine hypothesis.
        in: Nandkumar S Psychoneuroendocrine Dysfunction. Plenum, New York1984: 129-140
        • Heninger GR
        • Charney DC
        • Sternberg DE
        Serotonergic function in depression.
        Arch Gen Psychiatry. 1984; 41: 398-402
        • Hudson JI
        • Hudson MS
        • Rothschild AJ
        • Vignati L
        • Schatzberg AF
        • Melby JC
        Abnormal results of Dexmethasone Suppression Test in nondepressed patients with diabetes mellitus.
        Arch Gen Psychiatry. 1984; 41: 1086-1089
        • Jarrett DB
        • Coble PA
        • Kupfer DJ
        Reduced cortisol latency in depressive illness.
        Arch Gen Psychiatry. 1983; 40: 506-511
        • Jimerson DC
        • Insel TR
        • Reus VI
        • Kopin IJ
        Increased plasma MHPG in dexamethasone-resistant depressed patients.
        Arch Gen Psychiatry. 1983; 40: 173-176
        • Lee MA
        • Taylor MA
        Cortisol suppression and circadian rhythm in endogenous depression: A preliminary report.
        Biol Psychiatry. 1983; 18: 1127-1132
        • Meek JL
        • Neff NH
        Fluorometric estimation of 4-hydroxy-3-methoxyphenylethyleneglycol sulphate in brain.
        Br J Pharmacol. 1972; 45: 435-441
        • Muscettola G
        • Potter WZ
        • Pickar D
        • Goodwin FK
        Urinary 3-methoxy-4-hydroxyphenylglycol and major affective disorders.
        Arch Gen Psychiatry. 1984; 41: 337-342
        • Rosenbaum AH
        • Maruta T
        • Schatzberg AF
        • Orsulak Jiang N
        • Cole JO
        • Schildkraut JJ
        Toward a biochemical classification of depressive disorders, VII: Urinary free cortisol and urinary MHPG in depressions.
        Am J Psychiatry. 1983; 140: 314-317
        • Rush AJ
        • Giles DE
        • Roffwarg HF
        • Parker R
        Sleep EEG and Dexamethasone Suppression Test finding in outpatients with unipolar major depressive disorders.
        Biol Psychiatry. 1982; 17: 327-341
        • Schatzberg AF
        • Rothschild AJ
        • Stahl JB
        • Bond TC
        • Rosenbaum AH
        • Lofgren SB
        • MacLaughlin RA
        • Sulivan MA
        • Cole JO
        The Dexamethasone Suppression Test: Identification of subtypes of depression.
        Am J Psychiatry. 1983; 40: 88-91
        • Schildkraut JJ
        The catecholamine hypothesis of affective disorders. A review of supporting evidence.
        Am J Psychiatry. 1965; 122: 509-522
        • Schildkraut JJ
        • Orsulak PJ
        • Schatzberg AF
        • Gudeman JE
        • Cole JO
        • Rohde WA
        • LaBrie RA
        Toward a biochemical classification of depressive disorder: I. Difference in urinary excretion of MHPG and other catecholamine metabolites in clinically defined subtypes of depressions.
        Arch Gen Psychiatry. 1978; 35: 1427-1433
        • Schildkraut JJ
        • Schatzberg AF
        • Orsula PJ
        • Mooney JJ
        • Rosenbaum AH
        • Gudeman JE
        Biological discrimination of subtypes of depressions.
        in: Davis JM The Affective Disorders. American Psychiatric Press, Washington, DC1983: 31-51
      1. Manual of Epidemiological Study on Mental Disorders. People's Health Publishing House, Beijing1985
        • Spar JE
        • Rue AL
        Major depression in the elderly: DSM-III criteria and the Dexamethasone Suppression Test as predictors of treatment response.
        Am J Psychiatry. 1983; 140: 844-847
        • Stokes PE
        • Stoll PM
        • Koslow SH
        • Maas JW
        • Davis JM
        • Swann AC
        • Robins E
        Pretreatment DST and hypothalamic-pituitary-adrenocortical function in depressed patients and comparison groups.
        Arch Gen Psychaitry. 1984; 41: 257-267
        • Targum SD
        • Capodanno AE
        The Dexamethasone Suppression test in adolescent psychiatric inpatients.
        Am J Psychiatry. 1983; 140: 589-591
        • Wang YF
        • Shen YC
        Urinary 3-methoxy-4-hydroxyphenylglycol sulfate in school children with MBD syndrome.
        Chin J Neuropsychiatry. 1985; 1: 45-49
        • Yeh EL
        • Landis DH
        • Maas JW
        A method for the preparation and separation of 3-methoxy-4-hydroxyphenylethyleneglycol conjugates.
        Biochem Med. 1975; 14: 411-416
        • Zawad JS
        • Brown FC
        A fluorometric technique for measuring urinary 3-methoxy-4-hydroxyphenylethylene glycol.
        Clin Chim Acta. 1976; 73: 187-189