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Postdexamethasone Cortisol Levels and Subgroups of Affective Illness

Anthony J. Rothschild, MD; Alan F. Schatzberg, MD
Arch Gen Psychiatry. 1985;42(7):739-739. doi:10.1001/archpsyc.1985.01790300107017
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To the Editor.—  In their recent article on the use of biological markers in the assessment of patients with endogenous depression, Feinberg and Carroll1 found that unipolar depressed patients with endogenous depression had higher mean postdexamethasone cortisol values than their bipolar counterparts. In contrast, no differences were found in sleep studies between the two groups.Our group had previously reported differences on dexamethasone suppression test (DST) results between unipolar and bipolar depressed patients.2,3 It is thus gratifying to see a confirmation of our finding by these investigators. Prior to our reports,2,3 studies in the literature had generally failed to find significant differences between unipolar and bipolar patients in 4 PM postdexamethasone cortisol levels.4,5 Papakostas and associates6 found that 14 of 20 unipolar depressed patients were nonsuppressors, in contrast with zero of four bipolar depressed patients. In our study2 a higher percentage of unipolar (61%)

REFERENCES

Feinberg M, Carroll BJ:  Biological 'markers' for endogenous depression . Arch Gen Psychiatry 1984;;41:1080-1085.
Schatzberg AF, Rothschild AJ, Stahl JB, Bond TC, Rosenbaum AH, Lofgren SB, MacLaughlin RA, Sullivan MA, Cole JO:  The dexamethasone suppression test: Identification of subtypes of depression . Am J Psychiatry 1983;; 140:88-91.
Rothschild AJ, Schatzberg AF, Rosenbaum AH, Stahl JB, Cole JO:  The dexamethasone suppression test as a discriminator among subtypes of psychotic patients . Br J Psychiatry 1982;;141:471-474.
Schlesser MA, Winokur G, Sherman BM:  Hypothalamic-pituitary-adrenal axis activity in depressive illness: Its relationship to classification . Arch Gen Psychiatry 1980;;37:737-743.
Carroll BJ:  Neuroendocrine diagnosis of depression: The dexamethasone suppression test , in Clayton PJ, Barrett J (eds): Treatment of Depression: Old Controversies and New Approaches . New York, Raven Press, 1982;.
Papakostas Y, Fink M, Lee J:  Neuroendocrine measures in psychiatric patients: Course and outcome with ECT . Psychiatry Res 1981;;4:55-64.

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Feinberg M, Carroll BJ:  Biological 'markers' for endogenous depression . Arch Gen Psychiatry 1984;;41:1080-1085.
Schatzberg AF, Rothschild AJ, Stahl JB, Bond TC, Rosenbaum AH, Lofgren SB, MacLaughlin RA, Sullivan MA, Cole JO:  The dexamethasone suppression test: Identification of subtypes of depression . Am J Psychiatry 1983;; 140:88-91.
Rothschild AJ, Schatzberg AF, Rosenbaum AH, Stahl JB, Cole JO:  The dexamethasone suppression test as a discriminator among subtypes of psychotic patients . Br J Psychiatry 1982;;141:471-474.
Schlesser MA, Winokur G, Sherman BM:  Hypothalamic-pituitary-adrenal axis activity in depressive illness: Its relationship to classification . Arch Gen Psychiatry 1980;;37:737-743.
Carroll BJ:  Neuroendocrine diagnosis of depression: The dexamethasone suppression test , in Clayton PJ, Barrett J (eds): Treatment of Depression: Old Controversies and New Approaches . New York, Raven Press, 1982;.
Papakostas Y, Fink M, Lee J:  Neuroendocrine measures in psychiatric patients: Course and outcome with ECT . Psychiatry Res 1981;;4:55-64.

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