Lookup NU author(s): Dr Stuart Watson,
Dr Peter Gallagher,
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.
Author(s): Watson S, Gallagher P, Smith MS, Ferrier IN, Young AH
Publication type: Article
Publication status: Published
ISSN (print): 0306-4530
ISSN (electronic): 1873-3360
PubMed id: 16701957
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