Citation

Bostwick JM. Prim. Psychiatry 2005; 12(5): 49-52.

Copyright

(Copyright © 2005, MBL Communications)

DOI

unavailable

PMID

unavailable

Abstract

While the dexamethasone suppression test (DST) has not proven useful as a diagnostic test for "true" depression, it shows increasing promise as a potential indicator of psychiatric patients at increased risk for suicide. An indicator of the activity level of the hypothalamic-pituitary-adrenal (HPA) axis, the DST is an endocrine test that has caught the interest of psychiatric researchers throughout the last century because of the role of the HPA axis in managing an organism's homeostasis and stress response. This article will present a brief literature review of the role of the DST in psychiatry. It will propose a hypothesis, supported by data from two recent small studies, that suggests that chronic overdrive in the HPA axis, as manifested in a nonsuppressing DST, may result in an increased likelihood of suicide when the individual is acutely stressed.

Language: en

Keywords

human; mental health; suicide; survival; depression; stress; risk factor; review; hydrocortisone; anxiety disorder; melancholia; diagnostic accuracy; corticosteroid; brain dysfunction; neuroendocrinology; depressive psychosis; dexamethasone; dexamethasone suppression test; hypercortisolism; hypothalamus hypophysis adrenal system; agitation; hyperactivity; homeostasis