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The dexamethasone suppresion test (DST) was performed in panic disorder (PD) patients with (n = 32) or without (n = 31) agoraphobia and in normal controls (n = 49). Postdexamethasone serum cortisol levels were significantly higher in agoraphobic PD patients (105.3 ± 19.3 nmol/L) both when compared to PD patients withput agoraphobia (47.3 ± 7.7 nmol/L; p < 0.01) and when compared to healthy controls (51.7 ± 8.3 nmol/L; p < 0.01). The rate of nonsuppressors (i.e., subjects displaying postdexamethasone cortisol levels > 138 nmol/L) was 28% and 3% in agoraphobic and nonagoraphobic PD patients, respectively, and 12% in controls. In patients, the postdexamethasone cortisol levels did not correlate with the number of panic attacks per week, baseline anxiety as measured using the Hamilton Anxiety Scale, depressive symptoms as measured using the Montgomery-Åsberg Depression scale, or duration of illness. Data from eight patients in whom a second DST was performed after treatment with imipramine or clomipramine for three months indicate that a marked reduction of the number of anxiety attacks is not necessarily accompanied by a normalization of pathological DST. In conclusion, it is suggested that the elevated postdexamethasone cortisol levels sometimes observed in agoraphobic PD patients are more closely related to the agoraphobic behavior than to the panic attacks per se.
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- The DST in outpatients with generalized anxiety disorder, panic disorder or primary affective disorder.Am J Psychiatry. 1985; 142: 844-848
- Agoraphobia with panic attacks.Arch Gen Psychiatry. 1986; 43: 1029-1036
- Dexamethasone suppression test in patients with panic attacks.Biol Psychiatry. 1986; 21: 853-855
- Dexamethasone suppression test in patients with panic disorder and secondary depression.Arch Gen Psychiatry. 1982; 41: 723-724
- Clinical subtypes in panic disorder: their descriptive and prospective validity.J Affective Disord. 1986; 11: 105-114
- The dexamethasone suppression test for melancholia.Br J Psychiatry. 1982; 140: 292-304
- Abnormal escape from dexamethasone suppresion in agoraphobia with panic attacks.Psychiatry Res. 1985; 15: 301-311
- The significance of HPA axis disturbance in panic disorder.Biol Psychiatry. 1989; 25: 989-1002
- Le test à la dexamethasone dans l'agoraphobic avec attaques de panic.L'Encéphale. 1984; 10: 267-272
- The dexamethasone test in panic disorder and major depressive disorder and agoraphobia.Am J Psychiatry. 1982; 139: 1043-1046
- Biological markers in depression and panic disorder.in: Depression, anxiety and aggression. Medidact, Houten, The Netherlands1988: 39-53
- The dexamethasone test in panic disorder and major depressive disorder.Biol Psychiatry. 1986; 21: 1008-1014
- Panic disorder, agoraphobia and anxiety-relevants cognitive style.J Affective Disord. 1986; 11: 219-225
- The hypothalamic-pituitary-adrenal system in panic disorder.Am J Psychiatry. 1987; 144: 1320-1323
- The dexamethasone suppression test in inpatients with panic disorder or agoraphobia with panic attacks.Biol Psychiatry. 1987; 22: 513-517
- Abnormal dexamethasone suppresion test in normal females.Br J Psychiatry. 1983; 14: 489-497
- Repeated dexamethasone suppression test during depressive illness.J Affective Disord. 1982; 4: 93-101
- The dexamethasone suppression test in panic disorder.Pharmacopsychiatry. 1987; 20: 99-101
- Relationship of urinary free cortisol levels in patients with panic disorder to symptoms of depression and agorapobia.Psychiatry Res. 1988; 24: 211-221
- Direct comparison of urinary free cortisol excretion in patients with depression and panic disorder.Biol Psychiatry. 1989; 25: 873-878
- A model of panic and agoraphobic development.Acta Psychiatr Scand. 1987; 76: 87-95
- Pituitary adrenocortical unresposiveness in lactate-induce panic.Psychiatry Res. 1987; 21: 23-32
- Dexamethasone test in panic disorder patients.Am J Psychiatry. 1983; 140: 917-919
- Repeated dexamethasone suppression test in depressed patients.J Affective Disord. 1986; 11: 165-172
- Antidepressants in the treatment of panic disorder.Acta Psychiatr Scand. 1987; 76: 57-71
- Relationship between panic disorder and agoraphobia.Arch Gen Psychiatry. 1986; 43: 227-232
- The dexamethasone suppression test in agoraphobia.J Clin Psychopharmacol. 1985; 5: 100-103
- The dexamethasone test in panic disorder, comparison to normal controls.Biol Psychiatry. 1985; 12: 1234-1237
- Panic disorder and major depression: biological relationships.Psychopharmacol Bull. 1985; 21: 551-555
- Panic attacks and the dexamethasone suppression test.Am J Psychiatry. 1983; 140: 106
- Influence of hospital admission on DST results in patients with panic disorder.Am J Psychiatry. 1986; 143: 1315-1316
- The effect of benzodiazepine withdrawal on the dexamethasone suppression test.Acta Psychiatr Scand. 1988; 77: 232-234
- Agorapobia and the dexamethasone suppression test: atypical depression?.Aust NZ J Psychiatry. 1984; 18: 374-377
Received in revised form: February 23, 1991
Received: May 24, 1990
☆This study was supported by grants from the Swedish Medical Research Council (04752 and 08668), the Swedish Society of Medicine, and by CIBA-GEIGY Pharma Division, Sweden.
© 1991 Published by Elsevier Inc.