The dexamethasone suppression test as a predictor of suicidal behavior in unipolar depression

被引:72
作者
Yerevanian, BI
Feusner, JD
Koek, RJ
Mintz, J
机构
[1] VA Greater Los Angeles Healthcare Syst, Sepulveda Ambulatory Care Ctr, Los Angeles, CA USA
[2] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90024 USA
[3] W Los Angeles Vet Affairs Med Ctr, Biostat Consultat Unit, Los Angeles, CA 90073 USA
关键词
dexamethasone; depressive disorder; dysthymic disorder; suicide; attempted;
D O I
10.1016/j.jad.2004.08.009
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Non-suppression on the dexamethasone suppression test (DST) in unipolar depression has been found to be associated with completed suicide, with less consistent data for attempted suicide and hospitalizations for suicidality. The purpose of this study was to examine DST non-suppression as a predictor of these three aspects of suicidal behaviour. Methods: Records were reviewed for 101 patients who met criteria for major depressive disorder and/or dysthymic disorder and had a DST performed. All patients were treated naturalistically and were followed for an average of 2 years. DST suppressors and non-suppressors were compared with respect to three outcomes: (1) completed suicide; (2) attempted suicide; and (3) hospitalizations for suicidality. Results: DST non-suppressors were significantly more likely to have completed suicide or be hospitalized for suicidality than DST suppressors, with a non-significant trend for attempts. Total suicidal events were also significantly more frequent in the non-suppressor group. Limitations: Axis II diagnoses and,severity of illness were not assessed. Knowledge of DST results may have influenced the decision to hospitalize patients. Conclusions: DST non-suppression identifies unipolar depressed patients with a higher risk for future suicide completion or hospitalization for suicidality. Performance of DST upon initiation of treatment may be a useful adjunct in identifying suicidal risk. Published by Elsevier B.V.
引用
收藏
页码:103 / 108
页数:6
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