Munchausen syndrome, depression, and the dexamethasone suppression test.
The authors describe two patients with Munchausen syndrome who met DSM-III criteria for major depression. Both patients exhibited evidence of nonsuppression of serum cortisol by dexamethasone. Although many patients with Munchausen syndrome have been reported to be depressed, only a few have received a diagnosis of major depression. Because the physical and psychiatric symptoms of the Munchausen patient are so complex, clinical assessment may stop at a diagnosis of Munchausen syndrome, and major depression may be overlooked. A diagnosis of major depression should be considered in the evaluation of these patients; the dexamethasone suppression test may enhance clinical assessment.
D000328:Adult; D003866:Depressive Disorder / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D003907:Dexamethasone; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D009110:Munchausen Syndrome / Q000150:complications* / Q000523:psychology
D003907:Dexamethasone; D006854:Hydrocortisone