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Limited Utility of the 1-mg Dexamethasone Suppression Test as a Measure of Hypercortisolism-Reply

Peter E. Stokes, MD; Peter M. Stoll; Stephen H. Koslow, PhD; James W. Maas, MD; John M. Davis, MD; Alan C. Swann, MD; Eli Robins, MD
Arch Gen Psychiatry. 1985;42(2):202-204. doi:10.1001/archpsyc.1985.01790250096014.
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In Reply.—  Zimmerman and Coryell stated that our DST results in normal subjects are in marked contrast to those reported in the literature. Though Zimmerman and Coryell apparently raised only a question of differences in frequency of DST nonsuppression in normal subjects, this is in fact not a simple issue. The DST response is of intense research and possible clinical interest and it is important to understand that it is modified by many factors. Therefore, it is worth the time and effort to examine carefully our data, important factors influencing DST response, and the data cited by Zimmerman and Coryell. The Table lists by age group the nonsuppression frequency we observed in our 62 healthy control subjects with three post-DST plasma cortisol samples. Nonsuppression was most frequent in the 35- to 64-year-old age group. The mean age ( ± SD) of our healthy control subjects was 46 ±15 years (47 ±14 in depressed

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