Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-15T19:20:03.285Z Has data issue: false hasContentIssue false

Are depression and denutrition good predictors of dexamethasone suppression test (DST) in anorexia nervosa?

Published online by Cambridge University Press:  16 April 2020

C Massoubre
Affiliation:
Groupe de Recherche sur les Troubles de Conduite Alimentaire, Faculté de Médecine42023Saint Etienne cedex 2, France
F Lang
Affiliation:
Groupe de Recherche sur les Troubles de Conduite Alimentaire, Faculté de Médecine42023Saint Etienne cedex 2, France
L Millot
Affiliation:
Groupe de Recherche sur les Troubles de Conduite Alimentaire, Faculté de Médecine42023Saint Etienne cedex 2, France
M Pichon
Affiliation:
Groupe de Recherche sur les Troubles de Conduite Alimentaire, Faculté de Médecine42023Saint Etienne cedex 2, France
B Estour
Affiliation:
Groupe de Recherche sur les Troubles de Conduite Alimentaire, Faculté de Médecine42023Saint Etienne cedex 2, France
J Pellet
Affiliation:
Groupe de Recherche sur les Troubles de Conduite Alimentaire, Faculté de Médecine42023Saint Etienne cedex 2, France
Get access

Summary

This study was conducted to investigate the corticotropic axis in anorexia nervosa. In 93 female inpatients who met DSM-III-R criteria for anorexia nervosa, subsample (n = 64) with DSM-III criteria was also considered. Using stepwise regression analysis, this study examined the relationship between independent variables ie, age, body mass index, scores on depression scales and postdexamethasone serum cortisol, considered as a dependent variable. In patients who met DSM-III criteria, 16.7% of the variance of serum cortisol can be explained. The main predictors are depressive retardation, emaciation and age. Using stepwise logistic regression the main categorical predictors of the test suppression vs non suppression are of the same nature. The condition of realisation of DST are discussed.

Type
Research Article
Copyright
Copyright © Elsevier, Paris 1998

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abou-Samra, ABDechaud, HEstour, BChalendard, DFevre-Montange, MPugeat, Met al.Beta-lipotropin and cortisol response to an intravenous infusion dexamethasone suppression test in Cushing's syndrome and obesity J Clin Endocrinol Metab 1985; 61: 116119Google Scholar
Abou-Saleh, MTOleesky, DACrisp, AHLacey, JHDexamethasone suppression and energy balance in eating disorders Acta Psychiatr Scand 1986; 73: 242251Google Scholar
Akil, HMaskett, RFYoung, EAGrunhaus, LKotun, JWeinberg, Vet al.Multiple MPA profiles in endogenous depression: effect of age and sex on Cortisol and beta-endorphin Biol Psychiatry 1993; 33: 7385Google Scholar
Alexopoulos, GSYoung, RCKocsis, JHBrokner, NButler, TAStokes, PEDexamethasone suppression test in geriatric depression Biol Psychiatry 1984; 19: 15671571Google Scholar
Bardeleben (Von), UHolsboer, FLEffect of age on the cortisol response to human CRH in depressed patients pretreated with dexamethasone Biol Psychiatry 1991; 29: 10421050Google Scholar
Berger, MPirke, KMKrieg, JCVon Zerssen, DThe effect of weight loss and inappropriate plasma dexamethasone levels on the DST Psychiatry Res 1985; 15: 351360Google Scholar
Boyar, RMHellman, LDRoffwarg, HPCortisol secretion and metabolism in anorexia nervosa N Engl J Med 1977; 296: 190193Google Scholar
Braddock, LThe dexamethasone suppression test fact and artefact Br J Psychiatry 1986; 148: 363374Google Scholar
Brambilla, FCavagnini, FInvitti, CPoterzio, FLampertico, MSali, Let al.Neuroendocrine and psychopathological measures in anorexia nervosa: ressemblances to primary affective disorders Psychiatry Res 1985; 16: 165176Google Scholar
Carroll, BJCurtis, GCMendels, JNeuroendocrine regulation in depression discrimination of depressed from non depressed patients Arch Gen Psychiatry 1976; 33: 10511058CrossRefGoogle Scholar
Carrot, GLang, FEstour, BPellet, JGauthey, CWagon, CEtude de la EAT échelle d'autoévaluation de l'anorexie mentale dans une population témoin et dans une population d'anorexiques Ann Medico-Psychol 1987; 145: 258Google Scholar
Cooper, JLMorrison, TLBigman, OLAbramowitz, SILevin, SKrener, PMood changes and affective disorder in the bulimic binge purge cycle Int J Eating Disorders 1988; 7: 4694743.0.CO;2-O>CrossRefGoogle Scholar
Covi, LLipman, RMcnair, DMCrezlinsky, TSymptomatic volunteers in multicenter drug trials Prog Neuropsychopharmacology 1979; 3: 521CrossRefGoogle ScholarPubMed
Decrat, MLang, FChazot, LTatu, PBlanchon, YBerlier, JMDescription d'un échantillon de 300 echelles MADRS portant sur des sujets déprimés Ann Med Psychol 1987; 145: 170175Google Scholar
Doerr, PFichter, MPirke, KMLund, RRelationship between weight gain and hypothalamic pituitary adrenal function in patients with anorexia nervosa J Steroid Biochem 1980; 13: 529537CrossRefGoogle ScholarPubMed
Edelstein, CKRoy-Byrne, PFawzy, FIDornfels, LEffects of weight loss on the dexamethasone suppression test Am J Psychiatry 1983; 140: 338341Google ScholarPubMed
Estour, BPugeat, MLang, FLejeune, PBroutin, FPellet, Jet al.Rapid escape of cortisol from suppression in response to iv dexamethasone in anorexia nervosa Clin Endocrinol 1990; 33: 4552CrossRefGoogle Scholar
Feinberg, MCarroll, BJBiological markers and endogenous depression Arch Gen Psychiatry 1984; 41: 10801085CrossRefGoogle ScholarPubMed
Fichter, MMPirke, KMEffect of engerimental and pathological weight loss upon the hypothalamopituitary axis Psychoneuroendocrinology 1986; 11: 295305CrossRefGoogle Scholar
Fukata-Tamai, HTakaichi, YMori, KMatsubayashi, SNakaganat, TThe dexamethasone suppression test for Japanese with eating disorders Japan J Psychiatry Neurol 1988; 42: 5963Google Scholar
Garner, DMGarfinkel, PEThe eating attitudes test: an index of the symptoms of anorexia nervosa Psychol Med 1979; 9: 273279CrossRefGoogle ScholarPubMed
Gold, PWGwirtsman, HAvgerinos, PCNieman, LKGalluchi, WTKaye, Wet al.Abnormal hypothalamic-pituitary-adrenal function in anorexia nervosa pathophysiology mechanisms in underweight and weight corrected patients N Engl J Med 1986; 314: 13351342CrossRefGoogle ScholarPubMed
Gormley, GJLowy, MTReder, ATHospelhorn, VDAntel, JPMeztlzer, HYGlucocorticoid receptors in depression: relationship to the dexamethasone suppression test Am J Psychiatry 1986; 143: 12771284Google Scholar
Guthrie, SKVartanian, LGrunhaus, LHarinaran, MPande, AHaskett, RFA longitudinal evaluation of dexamethasone and cortisol plasma concentrations in the dexamethasone suppression test before and during treatment with antidepressant drugs Acta Psychiatr Scand 1990; 82: 427432CrossRefGoogle ScholarPubMed
Gwirtsman, HEGerner, RHNeurochemical abnormalities in anorexia nervosa: similarities to affective disorders Biol Psychiatry 1981; 16: 991995Google ScholarPubMed
Halmi, KARelationship of the eating disorders to depression: biological similarities and differences Int J Eating Disorders 1985; 4: 667680CrossRefGoogle Scholar
Herpertz-Dahlmann, BRemschmidt, MDie prognostische aussagekraft der dexamethason suppressions-tests für den verlauf der anorexia nervosa Z Kinder-Jugendpsychiatr 1990; 18: 511Google Scholar
Heuser, IYassouridis, AHolsboer, FThe combined dexamethasone/crh test: a refined laboratory test for psychiatric disorders J Psychiatry Res 1994; 28: 341356CrossRefGoogle ScholarPubMed
Hotta, MShibaski, TMasuda, AImaki, TDemura, HLing, Net al.The responses of plasma adrenocorticotropin and cortisol to CRF and cerebrospinal immunoreactive CRF in anorexia nervosa J Clin Endocrinol Metab 1986; 62: 319324CrossRefGoogle Scholar
Keitner, GRyan, CKohn, RMiller, INorman, WBrown, WAge and the dexamethasone suppression test: results from a broad unselected patient population Psychiatry Res 1992; 44: 920CrossRefGoogle ScholarPubMed
Kennedy, SHGarfinkel, PEStockl, SWhynot, DAMeasured weight loss and the DST Can J Psychiatry 1989; 34: 707709CrossRefGoogle Scholar
Lewis, DAPfohl, BSchlechte, JCoryell, WInfluence of age on the cortisol response to dexamethasone Psychiatry Res 1984; 13: 213220CrossRefGoogle ScholarPubMed
Maes, MJacobs, MPSuy, EMinner, BRaus, JPrediction of the DST results in depressives by means of urinary-free cortisol excretion dexamethasone levels and age Biol Psychiatry 1990; 28: 349357CrossRefGoogle ScholarPubMed
Meador-Woodruff, JHGreden, JFGrunhaus, LHaskett, RFSeverity of depression and hypothalamic-pituitary-adrenal axis dysregulation: identification of contributing factors Acta Psychiatr Scand 1990; 81: 364371CrossRefGoogle ScholarPubMed
Meikle, AWDexamethasone suppression tests: usefulness of simultaneous measurement of plasma cortisol and dexamethasone Clin Endocrinol 1982; 16: 401409CrossRefGoogle ScholarPubMed
Montgomery, SAAsberg, MA new depression scale designed to be sensitive to change Br J Psychiatry 1979; 134: 382389CrossRefGoogle ScholarPubMed
Oxenkrug, GFPomara, NMcIntyre, IMBranconnier, RJStanley, MGershon, SAgeing and cortisol resistance to suppression by dexamethasone: a positive correlation Psychiatry Res 1983; 10: 125130CrossRefGoogle ScholarPubMed
Pellet, JFaure, FLang, FCarrier, EBlanchon, YMarcon, MEtude de l'échelle de ralentissement sur un échantillon de sujets non ralentis non déprimés Psychol Méd 1986; 18: 10171020Google Scholar
Perez, ELBlouin, JBlouin, AThe dexamethasone suppression test in bulimia: non-suppression associated with depression and suboptimal weight J Clin Psychiatry 1988; 49: 9496Google Scholar
Schweitzer, ISzmukler, GIMaguire, KPHarrison, LCTuckwell, VDavies, BMThe dexamethasone suppression test in anorexia nervosa: the influence of weight depression adrenocosticotrophic hormone and dexamethasone Br J Psychiatry 1990; 157: 713717CrossRefGoogle ScholarPubMed
Sherman, BWasharm, CPfohl, BAge related changes in the circadian rhythm of plasma coritsol in man J Clinic Endocrinol Metab 1985; 61: 439443CrossRefGoogle Scholar
Staner, LMaes, MBouillon, ELinkowski, PBiological correlates of the new castle in depressive illness: a multivariate approach Acta Psychiatr Scand 1992; 85: 345350CrossRefGoogle Scholar
Stokes, PEStoll, PMKoslow, SAA retreatment DST and hypothalamic pituitary adrenocostral function in depressed patients and comparison groups Arch Gen Psychiatry 1984; 41: 257267CrossRefGoogle Scholar
Tiller, JWGMaguire, KPSchweitzer, IBiddle, NCampbell, DGOntch, Ket al.The dexamethasone suppression test: a study in a normal population Psychoneuroendocrinology 1988; 13: 377384CrossRefGoogle Scholar
Walsh, TBKatz, JLLevin, JKream, JFukushima, DKWeiner, Het al.The production rate of cortisol declines during recovery from anorexia nervosa J Clin Endocrinol Metab 1981; 53: 203205CrossRefGoogle ScholarPubMed
Weiner, HThe hypothalamic pituitary ovarian axis in anorexia and bulimia nervosa Int J Eating Disorders 1983; 2: 1091163.0.CO;2-J>CrossRefGoogle Scholar
Widlöcher, DLecrubier, YLe Goc, IThe place of anxiety in depressive symptomatology Br J Clin Pharmacology 1983; 15: 171S179SCrossRefGoogle ScholarPubMed
Widlöcher, DPsychomotor Retardation: Clinical, and Psychometric Aspects Diagnosis and treatment of Affective Disorders Psychiatr Clin North Am 1983; 6: 2740CrossRefGoogle Scholar
Winterer, JGwirtsman, HEGoerge, DTKaye, WHLoriaux, DLGutler, GBAdrenocorticotropin stimulated adrenal androgen secretion in anorexia nervosa: impaired secretion at low weight with normalisation after long-term recovery J Clin Endocrinol Metabolism 1985; 61: 693697CrossRefGoogle Scholar
Zimmerman, MCoryell, WHBlack, DWVariability in the application of contemporary diagnostic criteria: endogenous depression as an example Am J Psychiatry 1990; 147: 11731179Google ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.