A Specific Laboratory Test for the Diagnosis of Melancholia

Standardization, Validation, and Clinical Utility

Bernard J. Carroll, Michael Feinberg, John F. Greden, Janet Tarika, A. Ariav Albala, Roger F. Haskett, Norman McI James, Ziad Kronfol, Naomi Lohr, Meir Steiner, Jean Paul Vigne, Elizabeth Young

Research output: Contribution to journalArticle

1602 Citations (Scopus)

Abstract

Four hundred thirty-eight subjects underwent an overnight dexamethasone suppression test (DST) to standardize the test for the diagnosis of melancholia (endogenous depression). Abnormal plasma cortisol concentrations within 24 hours after dexamethasone administration occurred almost exclusively in melancholic patients. The best plasma cortisol criterion concentration, above which a DST result may be considered abnormal, was 5 ug/dL. The optimal dose of dexamethasone was 1 rather than 2 mg. Two blood samples obtained at 4 and 11 PM after dexamethasone administration detected 98% of the abnormal test results. This version of the DST identified melancholic patients with a sensitivity of 67% and a specificity of 96%. Baseline nocturnal plasma cortisol concentrations were not useful. Abnormal DST results were found with similar frequency among outpatients and inpatients with melancholia; but they were not related to age, sex, recent use of psychotropic drugs, or severity of depressive symptoms. Extensive evidence validates this practical test for the diagnosis of melancholia.

Original languageEnglish
Pages (from-to)15-22
Number of pages8
JournalArchives of General Psychiatry
Volume38
Issue number1
DOIs
Publication statusPublished - 1981
Externally publishedYes

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Clinical Laboratory Techniques
Depressive Disorder
Dexamethasone
Hydrocortisone
Psychotropic Drugs
Standardization
Melancholia
Inpatients
Outpatients
Depression
Suppression
Cortisol
Plasma

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Psychiatry and Mental health

Cite this

Carroll, B. J., Feinberg, M., Greden, J. F., Tarika, J., Albala, A. A., Haskett, R. F., ... Young, E. (1981). A Specific Laboratory Test for the Diagnosis of Melancholia: Standardization, Validation, and Clinical Utility. Archives of General Psychiatry, 38(1), 15-22. https://doi.org/10.1001/archpsyc.1981.01780260017001

A Specific Laboratory Test for the Diagnosis of Melancholia : Standardization, Validation, and Clinical Utility. / Carroll, Bernard J.; Feinberg, Michael; Greden, John F.; Tarika, Janet; Albala, A. Ariav; Haskett, Roger F.; McI James, Norman; Kronfol, Ziad; Lohr, Naomi; Steiner, Meir; Vigne, Jean Paul; Young, Elizabeth.

In: Archives of General Psychiatry, Vol. 38, No. 1, 1981, p. 15-22.

Research output: Contribution to journalArticle

Carroll, BJ, Feinberg, M, Greden, JF, Tarika, J, Albala, AA, Haskett, RF, McI James, N, Kronfol, Z, Lohr, N, Steiner, M, Vigne, JP & Young, E 1981, 'A Specific Laboratory Test for the Diagnosis of Melancholia: Standardization, Validation, and Clinical Utility', Archives of General Psychiatry, vol. 38, no. 1, pp. 15-22. https://doi.org/10.1001/archpsyc.1981.01780260017001
Carroll, Bernard J. ; Feinberg, Michael ; Greden, John F. ; Tarika, Janet ; Albala, A. Ariav ; Haskett, Roger F. ; McI James, Norman ; Kronfol, Ziad ; Lohr, Naomi ; Steiner, Meir ; Vigne, Jean Paul ; Young, Elizabeth. / A Specific Laboratory Test for the Diagnosis of Melancholia : Standardization, Validation, and Clinical Utility. In: Archives of General Psychiatry. 1981 ; Vol. 38, No. 1. pp. 15-22.
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