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The dex/CRH test-Is it better than the DST?

Lookup NU author(s): Dr Stuart Watson, Dr Peter GallagherORCiD, Margaret Smith, Emeritus Professor Nicol Ferrier, Professor Allan Young


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The dexamethasone suppression test (DST), frequently abnormal in mood disorder patients, is considered to measure glucocorticoid receptor-mediated negative feedback. We examined the hypothesis that the, apparently more sensitive, dexamethasone/corticotrophin-releasing-hormone (dex/CRH) test unveils subtle hypothalamic-pituitary-adrenal axis disturbance not detected by the DST in 82 patients with mood disorders and 28 controls. There was a close correlation between the cortisol responses on the two tests (rs=0.73, p<0.0005). However, ROC analysis revealed that the dex/CRH test had better diagnostic performance than the DST (p=0.031). The sensitivity of delta cortisol (from the dex/CRH) was 61.9% and the specificity 71.4%. The sensitivity of 1500 h cortisol (the DST) was 66.6% and the specificity was 47.6%. This suggests that the two tests measure common pathology but that the dex/CRH test has better diagnostic utility. © 2006 Elsevier Ltd. All rights reserved.

Publication metadata

Author(s): Watson S, Gallagher P, Smith MS, Ferrier IN, Young AH

Publication type: Article

Publication status: Published

Journal: Psychoneuroendocrinology

Year: 2006

Volume: 31

Issue: 7

Pages: 889-894

ISSN (print): 0306-4530

ISSN (electronic): 1873-3360

Publisher: Pergamon


DOI: 10.1016/j.psyneuen.2006.03.001

PubMed id: 16701957


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