Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-17T01:35:18.971Z Has data issue: false hasContentIssue false
  • English
  • Français

Dexamethasone Suppression Test in Dementia and Depression

Clinical and Biological Correlates

Published online by Cambridge University Press:  02 January 2018

J. Shrimankar ,
Som D. Soni  and
J. McMurray
J. Shrimankar
Affiliation:
Prestwich Hospital, Prestwich, Manchester M25 7BL
Som D. Soni*
Affiliation:
Salford Health Authority, Prestwich Hospital, Prestwich, Manchester M25 7BL
J. McMurray
Affiliation:
Department of Chemical Pathology, Hope Hospital, Salford M6 8HD
*
∗Correspondence
Get access Rights & Permissions [Opens in a new window]

Abstract

To determine the usefulness of the DST in differentiating depression from dementia, the test was administered to three diagnostic groups of psychogeriatric patients: depression; dementia; and dementia with depression. Clinical assessments were supplemented by ratings on the HRSD and SCAG, as well as by EEG and CT. All three groups showed a high incidence of abnormal DST results unrelated to presence or severity of affective symptoms, but showing a better association with SCAG and its ‘organic’ subsets. The mechanism(s) underlying these abnormal results may reflect organic brain disease. The usefulness of the DST in differentiating depression from dementia in the elderly was not confirmed.

Type
Papers
Information
The British Journal of Psychiatry , Volume 154 , Issue 3 , March 1989 , pp. 372 - 377
Copyright
Copyright © Royal College of Psychiatrists, 1989 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abou-Saleh, M. T., Spalding, E. M., Kellett, J. M., et al (1987) Dexamethasone suppression test in dementia. International Journal of Geriatric Psychiatry, 2, 59–65.Google Scholar
American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM-III). Washington, DC: APA.Google Scholar
Balldin, J., Gottfries, C., Karlsson, I., et al (1983) Dexamethasone suppression test and serum prolactin in dementia disorders. British Journal of Psychiatry, 143, 277–281.Google Scholar
Beckett, G. J., Gray, S. M. & Seth, J. (1982) In Immunoassays for Clinical Chemistry (2nd edn) (eds Hunter, W. M. & Corrie, J. E. T.) pp. 201–202. London: Churchill Livingstone.Google Scholar
Berger, M., Pirkie, K.-M., Doerr, P., et al (1984) The limited utility of the dexamethasone suppression test for the diagnostic process in psychiatry. British Journal of Psychiatry, 145, 372–382.Google Scholar
Bondareff, W., Mountjoy, C. Q. & Roth, M. (1981) Selective loss of neurones of origin of adrenergic projection to the cerebral cortex (nucleus locus coerulus) in senile dementia. Lancet, i, 783–784.Google Scholar
Bowen, D. M., White, P., Falck, R. H. A., et al (1974) Brain-decarboxylase activities as indices of pathological change in senile dementia. Lancet, i, 1247–1249.Google Scholar
Bowen, D. M., Smith, C. B., White, P., et al (1976) Neurotransmitter-related enzymes and indices of hypoxia in senile dementia and other abiotrophies. Brain, 99, 459–496.Google Scholar
Branconnier, R. J., Oxenkrug, G. F., McIntyre, L., et al (1984) Prediction of serum cortisol response to dexamethasone in normal volunteers: a multivariate approach. Psychopharmacology, 84, 274–275.Google Scholar
Carnes, M., Smith, J. C., Kalin, N. H., et al (1983) Effects of chronic medical illness and dementia on the dexamethasone suppression test. Journal of American Geriatric Society, 31, 267 271.Google Scholar
Carroll, B. J. (1982) The dexamethasone suppression test for melancholia. British Journal of Psychiatry, 140, 292–304.CrossRefGoogle ScholarPubMed
Carroll, B. J., Feinberg, M., Greden, J. F., et al (1981) A specific laboratory test for the diagnosis of melancholia. Standardisation, validation and clinical utility. Archives of General Psychiatry, 38, 15–22.Google Scholar
Coppen, A., Abou-Saleh, P., Milln, P., et al (1983) Does dexamethasone suppression test predict antidepressant treatment success? British Journal of Psychiatry, 142, 498–504.Google Scholar
Dilman, V. M., Lapin, I. P. & Oxenkrug, G. F. (1979) Serotonin and ageing. In Serotonin in Health and Disease (ed. Essman, W. B.). New York: Spectrum Publications.Google Scholar
Folstein, M. F. & McHugh, P. R. (1978) Dementia syndrome of depression. In Alzheimer's Disease, Senile Dementia and Related Disorders (eds Katzman, R., Terry, R. D. & Bick, K. L.). New York: Raven Press.Google Scholar
Georgotas, A., McCue, R. E., Kim, M., et al (1986) Dexamethasone suppression test in dementia, depression and normal ageing. American Journal of Psychiatry, 143, 452–456.Google Scholar
Greenwald, B. S., Mathe, A. A., Mohs, R. C., et al (1986) Cortisol and Alzheimer's disease. II: Dexamethasone suppression, dementia severity and affective symptoms. American Journal of Psychiatry, 143, 442–446.Google ScholarPubMed
Hamilton, M. (1967) Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology, 6, 278–296.CrossRefGoogle ScholarPubMed
Katona, C. L. E. & Aldridge, C. R. (1985) The dexamethasone suppression test and depressive signs in dementia. Journal of Affective Disorders, 8, 83–89.Google Scholar
Mann, D. M. A., Lincoln, J., Yates, P. O., et al (1980) Changes in monoamine containing neurones of the human CNS in senile dementia. British Journal of Psychiatry, 136, 533–541.Google Scholar
Mann, D. M. A. & Yates, P. O. (1983) Serotonin nerve cells in Alzheimer's disease. Journal of Neurology, Neurosurgery and Psychiatry, 46, 96.Google Scholar
Mann, D. M. A., Yates, P. O., & Marcyniuk, B. (1985) Some morphometry observations on the cerebral cortex and hippocampus in presenile Alzheimer's disease, senile dementia of Alzheimer type and Down's syndrome in middle age. Journal of Neurological Science, 69, 139–159.Google Scholar
Marsden, C. D. & Harrison, M. J. G. (1972) Outcome of investigation of patients with presenile dementia. British Medical Journal, ii, 249–252.Google Scholar
McAllister, T. W., Ferrell, R. B., Price, T. R. P., et al (1982) The dexamethasone suppression test in two patients with severe depressive pseudodementia. American Journal of Psychiatry, 139, 479–481.Google Scholar
McKeith, I. G. (1984) Clinical use of the DST in a psychogeriatric population. British Journal of Psychiatry, 145, 389–393.CrossRefGoogle Scholar
Nott, P. N. & Fleminger, J. J. (1975) Presenile dementia: the difficulties of early diagnosis. Acta Psychiatrica Scandinavica, 51, 210–217.Google Scholar
O'Neal, P., Robins, E. & Schmidt, E. H. (1956) A psychiatric study of attempted suicide in persons over sixty years of age. Archives of Neurologie and Psychiatry, 75, 275.Google Scholar
Oxenkrug, G. F., Pomara, N., McIntyre, L., et al (1983) Ageing and cortisol resistance to suppression by dexamethasone: a positive correlation. Psychiatry Research, 10, 125–130.CrossRefGoogle ScholarPubMed
Pearson, R. C. A., Esiri, M. M., Hirons, R. W., et al (1985) Anatomical correlates of the distribution of the pathological changes in the neocortex in Alzheimer's disease. Proceedings of the National Academy of Sciences, USA, 82, 4531–4534.Google Scholar
Perry, E. K., Perry, R. H., Blessed, G., et al (1977) Necropsy evidence of central cholinergic deficits in senile dementia. Lancet, i, 189.Google Scholar
Post, F. (1962) The Significance of Affective Symptoms in Old Age. London: Oxford University Press.Google Scholar
Post, F. (1975) Dementia, depression and pseudodementia. In Psychiatric Aspects of Neurologic Disease (eds Benson, D. F. & Blumer, D.). New York: Grune and Stratton.Google Scholar
Raskind, M., Peskind, E., Rivard, M. F., et al (1982) Dexamethasone suppression test and cortisol rhythms in primary degenerative dementia. American Journal of Psychiatry, 139, 1468–1471.Google Scholar
Reisine, T. D., Yamamura, H. I., Bird, E. D. et al (1978) Pre- $and post-synaptic neurochemical alterations in Alzheimer's disease. Brain Research, 159, 477–481.Google Scholar
Rudorfer, M. V. & Clayton, P. J. (1982) Pseudodementia – use of the DST in diagnosis and treatment monitoring. Psychosomatics, 23, 429–431.Google Scholar
Sim, M. (1985) Alzheimer's disease: a forgotten entity. Geriatrics, 20, 668–674.Google Scholar
Shader, R. I. (1974) A new scale for clinical assessment in geriatric populations: Sandoz Clinical Assessment – Geriatric (SCAG). Journal of the American Geriatric Society, 22, 107–113.Google Scholar
Shrimankar, J., Soni, S. D. & Sampath, G. (1988) Dexamethasone suppression test and response to antidepressant therapy in psychogeriatric patients. Acta Psychiatrica Scandinavica, 77, 712–718.Google Scholar
Slater, E. & Roth, M. (1969) Clinical Psychiatry, p. 9. London: Bailliere Tindall.Google Scholar
Spar, J. E. & Gerner, R. (1982) Does dexamethasone suppression test distinguish dementia from depression? American Journal of Psychiatry, 139, 238–240.Google ScholarPubMed
Sulkava, R., Haltia, M., Paetau, A., et al (1983) Accuracy of clinical diagnosis in primary degenerative dementia: correlation with neuropathological findings. Journal of Neurology, Neurosurgery and Psychiatry, 46, 9–13.Google Scholar
Tourigny-Rivard, M. F., Raskind, M. & Rivard, D. (1981) The dexamethasone suppression test in an elderly population. Biological Psychiatry, 16, 1177–1184.Google Scholar
Venn, R. D. (1983) The Sandoz Clinical Assessment – Geriatric (SCAG) scale. A general purpose psychogeriatric rating scale. Gerontology, 29, 185–198.Google Scholar
Wells, C. E. (1979) Pseudodementia. American Journal of Psychiatry, 136, 895–900.Google Scholar
Yates, C., Ritchie, E., Simpson, J., et al (1981) Noradrenaline in Alzheimer-type dementia and Down syndrome. Lancet, ii, 39–40.CrossRefGoogle Scholar
Submit a response

eLetters

No eLetters have been published for this article.