Plasma cortisol and 11-deoxycortisol activity in depressed patients and normal volunteers.
Plasma cortisol and 11-deoxycortisol were measured in 30 depressed patients and 110 normal volunteers before and after a 1.0 mg dexamethasone suppression test (DST). Post-dexamethasone plasma cortisol, 11-deoxycortisol and the cortisol/11-deoxycortisol ratio were significantly higher in the depressives compared to the controls, even when age and sex were taken into account. Pre-dexamethasone plasma cortisol, post-dexamethasone cortisol, 11-deoxycortisol and their ratio were significantly higher in the cortisol nonsuppressors than in the suppressors. The measurement of post-dexamethasone 11-deoxycortisol and the ratio did not differentiate between endogenous and reactive depression. Using the normative data, we explored several methods for determining a criterion value to define abnormal post-dexamethasone plasma 11-deoxycortisol and the cortisol/11-deoxycortisol ratio in depressed patients. All showed poor sensitivity and a low positive predictive value for depression. The measurement of 11-deoxycortisol thus does not enhance the clinical utility of the DST.
Schweitzer
I
I
Department of Psychiatry, University of Melbourne, Australia.
Tuckwell
V M
VM
Maguire
K P
KP
Tiller
J W
JW
Harrison
L C
LC
Davies
B M
BM
D000328:Adult; D000368:Aged; D003350:Cortodoxone / Q000097:blood*; D003866:Depressive Disorder / Q000097:blood* / Q000175:diagnosis / Q000523:psychology; D003907:Dexamethasone; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D011569:Psychiatric Status Rating Scales; D012016:Reference Values
D003907:Dexamethasone; D003350:Cortodoxone; D006854:Hydrocortisone