The use of the dexamethasone suppression test in the evaluation of depression: A re-examination

Abstract

The clinical and research usefulness of the dexamethasone suppression test (DST) in diagnosis of endogenous depression has become the subject of considerable controversy. Following the original report on the standardization of this test, subsequent studies often deviated in significant ways in methodology. The present study of 107 subjects was undertaken to determine the specificity and sensitivity of the DST utilizing a methodology similar to that of the original report. The sensitivity of the DST was 57 percent for definite endogenous depressive disorder and 7 percent for nonendogenous depression. The specificity and predictive value of the DST for endogenous depression were 82 percent and 89 percent, respectively. These results are quite comparable to those of the original standardization study. These data support the validity of the DST as a biologic marker for endogenous depression, and, when properly utilized, the test can be an effective adjunctive tool for confirming the clinical diagnosis of this disorder.