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The Utility of the Dexamethasone Suppression Test

Randal D. France, MD; K. Ranga Rama Krishnan, MD
Arch Gen Psychiatry. 1987;44(1):95. doi:10.1001/archpsyc.1987.01800130107017.
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To the Editor.—  IN the December 1985 issue of the Archives, Arana and colleagues1 extensively review the use of the dexamethasone suppression test (DST) in various clinical states and comment on the "ability of the DST to differentiate depression from selected, clinically pertinent conditions." The authors summarize the DST results in major depressive disorder vs the selected comparison groups in Table 5 of their article. Chronic pain is one of the selected comparison groups, and the authors quote from two references2,3 on chronic pain and major depressive disorder and one reference on chronic pain4 to calculate the sensitivity and specificity of the DST. It should be noted that two of the references2,3 refer to a study of the DST but contain no mention of the DST in patients with chronic pain. The article by Blumer et al5 does indeed report on the results of the


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