HPA axis hyperactivity and recovery from functional psychoses.
Some patients with functional psychoses follow a chronic, deteriorating course and others recover; at present clinicians have essentially no established factors beyond diagnosis and chronicity to predict which course a psychotic patient might follow. Because data on diagnostic specificity suggested that the dexamethasone suppression test might provide another, much needed prognostic factor, the authors administered these tests to 98 consecutively admitted patients with nonmanic psychoses. High postdexamethasone cortisol levels (6 micrograms/dl or higher) at baseline predicted recovery from psychosis at 1 year, independent of episode chronicity and diagnosis. Diagnosis did not correspond well to test results but was itself an important predictor.
Coryell
W H
WH
Department of Psychiatry, University of Iowa, Iowa City 52242.
Zimmerman
M
M
D000328:Adult; D003866:Depressive Disorder / Q000503:physiopathology; D003907:Dexamethasone; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D011379:Prognosis; D011618:Psychotic Disorders / Q000175:diagnosis / Q000503:physiopathology*; D012559:Schizophrenia / Q000503:physiopathology
D003907:Dexamethasone; D006854:Hydrocortisone