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The Dexamethasone Suppression Test and Suicidal Patients

  • Jon Ennis (a1), Rosemary A. Barnes (a1) and Sidney Kennedy (a1)


The dexamethasone suppression test (DST) was used in an in-patient crisis unit to determine whether the test could identify suicidal patients who might benefit from tricyclic antidepressants. DST results, DSM-III diagnoses, and measures of symptom levels were obtained for 72 patients admitted for a 3–5 day period; 31 were non-suppressors. Abnormal DST results were not related to DSM-III diagnosis or to scores on measures of depression and symptom levels. Only three patients met DSM-III criteria for major depression with melancholia; 26 patients had a diagnosis of alcohol or substance abuse. The poor specificity of the DST in this patient population suggests that its routine use in such patients could be highly misleading.


Corresponding author

Dr. Jon Ennis, Department of Psychiatry, Toronto General Hospital, Eaton Building, Eighth Floor, 101 College Street, Toronto, Ontario, M5G 1L7, Canada


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Adam, K. S., Bouc Koms, A. & Scarr, G. (1980) Attempted suicide in Christchurch: a controlled study. Australian and New Zealand Journal of Psychiatry, 14, 305314.
American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders. Third Edition. Washington, DC: American Psychiatric Association.
Asberg, M., Traskman, L. & Thoren, P. (1976) 5-HIAA in the cerebrospinal fluid. A biochemical suicide predictor? Archives of General Psychiatry, 33, 11921197.
Bailey, J. & Coppen, A. (1976) A comparison between the Hamilton rating scale and the Beck inventory in the measurement of depression. British Journal of Psychiatry, 128, 486489.
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J. & Erbaugh, J. (1961) An inventory for measuring depression. Archives of General Psychiatry, 4, 561571.
Bunney, W. E., Fawcett, J. A., Davis, J. M. & Gifford, S. (1969) Further evaluation of urinary 17-hydroxycorticosteroid in suicidal patients. Archives of General Psychiatry, 21, 138150.
Carroll, B. J. (1982) The dexamethasone suppression test for melancholia. British Journal of Psychiatry, 140, 292304.
Carroll, B. J. Curtis, G. C. & Mendels, J. (1976) Neuroendocrine regulation in depression—II: discrimination of depressed from non-depressed patients. Archives of General Psychiatry, 33, 10511058.
Carroll, B. J. Feinberg, M., Greden, J. F., Tarika, J., Albala, A., Haskett, R., James, N., Lohr, N., Steiner, M., DeVigne, J. & Younge, E. (1981a) A laboratory test for the diagnosis of melancholia. Archives of General Psychiatry, 38, 1522.
Carroll, B. J. Gredon, J. F. & Feinberg, M. et al (1981b) Neuroendocrine evaluation of depression in borderline patients. Psychiatric Clinics of North America, 4, 8990.
Coccaro, E. F., Prudic, J., Rothpearl, A. & Nurnberg, H. G. (1984) Effect of hospital admission on DST results. American Journal of Psychiatry, 141, 982985.
Coppen, A., Aboul-Saleh, M., Milln, P., Metcalfe, M., Harwood, J. & Bailey, J. (1983) Dexamethasone test in depression and other psychiatric illnesses. British Journal of Psychiatry, 142, 498504.
Coryell, W., Gaffney, G. & Burkhardt, P. (1982) DSM-III melancholia and the primary-secondary distinction: A comparison of concurrent validity by means of the dexamethasone suppression test. American Journal of Psychiatry, 139, 120122.
Coryell, W., Gaffney, G. & Sschlesser, M. A. (1981) Suicide and the dexamethasone suppression test in unipolar depression. American Journal of Psychiatry, 138, 11201121.
Curtin, G. C., Cameron, O. G. & Nesse, R. M. (1982) The dexamethasone suppression test in panic disorder and agoraphobia. American Journal of Psychiatry, 139, 10431046.
Fanc, V. S., Warenica, B. & Meltzer, H. Y. (1982) Dexamethasone suppression test technique and accuracy. Archives of General Psychiatry, 39, 1217.
Gibbons, J. L., Gibson, J. G., Maxwell, A. E. & Wilcox, D. R. C. (1960) An endocrine study of depressive illness. Journal of Psychiatric Research, 1, 162171.
Goldberg, D. (1972) The detection of psychiatric illness by questionnaire. London: Oxford University Press.
Goldney, R., Adam, K., O'Brien, J. & Termansen, P. (1981) Depression in young women who have attempted suicide. Journal of Affective Disorders, 3, 327337.
Hallstrom, T., Samuelson, S., Balldin, J., Walinder, J., Bergtsson, C., Nystrom, E., Andersch, B., Lindstedt, G. & Lundberg, P. (1983) Abnormal suppression test in normal females. British Journal of Psychiatry, 142, 489497.
Hawton, K. & Catalan, J. (1982) Attempted Suicide: A Practical Guide to its Nature and Management. London: Oxford University Press.
Kreitman, N. (ed.) (1977) Parasuicide. Chichester: John Wiley.
Morgan, H. G. (1979) Death Wishes? Chichester: John Wiley.
Newson, G. & Murray, N. (1983) Reversal of dexamethasone suppression test nonsuppression in alcohol abusers. American Journal of Psychiatry, 140, 353354.
Newson-Smith, J. G. B. & Hirsch, S. R. (1979) Psychiatric symptoms in self-poisoning patients. Psychological Medicine, 9, 493500.
Prabhu, V. & El-Guebaly, N. (1983) Cortisol secretion and DST in affective disorders—methodological concerns. Canadian Journal of Psychiatry, 28, 602611.
Rose, L. I., Blumenfield, M., Richmond, L. H. et al (1970) Dexamethasone suppression in emotional stress. Clinical Research, 18, 34.
Sachar, E. J., Hellman, L., Fukushim, D. K. & Gallagher, T. F. (1970) Cortisol production in depressive illness. A clinical and biochemical clarification. Archives of General Psychiatry, 23, 239298.
Silver, M. A., Bohnert, M., Beck, A. T. & Marcus, D. (1971) Relation of depression of attempted suicide and seriousness of intent. Archives of General Psychiatry, 25, 573576.
Stokes, P. E., Stoll, P. M., Mattson, M. R. & Sollod, R. N. (1976) Diagnosis and psychopathology resistant to dexamethasone. In Hormones, Behaviour and Psychopathology (ed. Sachar, E. J.). New York: Raven Press.
Targum, S. D., Rosen, L. & Capodanno, A. E. (1983) The dexamethasone suppression test in suicidal patients with unipolar depression. American Journal of Psychiatry, 140, 877879.
Wong, P. Y., Mee, A. V. & Ho, F. F. K. (1979) A direct radioimmunoassay of serum cortisol with in-house 125 l-tracer and pre-conjugated double antibody. Clinical Chemistry, 25, 914917.
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The Dexamethasone Suppression Test and Suicidal Patients

  • Jon Ennis (a1), Rosemary A. Barnes (a1) and Sidney Kennedy (a1)
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