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Dexamethasone Suppression Test and Subtypes of Depression-Reply

Michael A. Schlesser, MD; George Winokur, MD; Barry Sherman, MD
Arch Gen Psychiatry. 1981;38(3):363-364. doi:10.1001/archpsyc.1981.01780280131018.
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In Reply.—  Drs Sternbach, Gwirtsman, and Gerner raised an important point. We believe that we have demonstrated the validity of the three subtypes of depression because we have presented both an original finding and a replication. In both sets of data, the numbers are large and comparable to those of some of the more extensive DST studies. The postdexamethasone sampling was done at 8 AM. In our Archives article, 76% of the familial pure depressives were abnormal suppressors, as opposed to only 7% of the patients with DSD. We cannot make much out of the sporadic depressive group because of the fact that their disorder is assessed by virtue of a negative finding rather than a positive finding. It is quite possible that the sporadic group is composed of a variety of different types of patients who show a negative first-degree family history for a number of reasons. In any event, the


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