The Dexamethasone Suppression Test in children and adolescents: A review and a controlled study

Ronald E. Dahl, Joan Kaufman, Neal D. Ryan, James Perel, Mayadah Al-Shabbout, Boris Birmaher, Beverly Nelson, Joaquim Puig-Antich

Research output: Contribution to journalArticlepeer-review

Abstract

Dexamethasone Suppression Test (DST) studies conducted in children and adolescents are reviewed, together with factors hypothesized to explain discrepancies in rates of DST nonsuppression across studies. These factors are then examined in a controlled study of 27 adolescents with major depressive disorder (MDD) and 34 normal controls (NC). subjects were given 1 mg of dexamethasone at 11:00 pm, and the following day serum samples for cortisol were collected each hr from 8 am to 11 pm through an indwelling catheter. There were no significant differences found between the MDD and NC subjects on any postdexamethasone cortisol measure. Further, cortisol suppressors and nonsuppressors were not distinguished by any of the hypothesized factors identified from the review, including inpatient status, presence of suicidality, endogenous features, psychotic symptoms, or prior history of MDD. Questions about the appropriateness of the 1 mg dose of dexamethasone (currently the standard dose used with adolescents) are raised, together with a discussion of the effects of stress on DST findings.

Original languageEnglish (US)
Pages (from-to)109-126
Number of pages18
JournalBiological psychiatry
Volume32
Issue number2
DOIs
StatePublished - Jul 15 1992
Externally publishedYes

ASJC Scopus subject areas

  • Biological Psychiatry

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