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The dex/CRH test--is it better than the DST?
Psychoneuroendocrinology. 2006 Aug; 31(7):889-94.P

Abstract

The dexamethasone suppression test (DST), frequently abnormal in mood disorder patients, is considered to measure glucocorticoid receptor-mediated negative feedback. We examined the hypothesis that the, apparently more sensitive, dexamethasone/corticotrophin-releasing-hormone (dex/CRH) test unveils subtle hypothalamic-pituitary-adrenal axis disturbance not detected by the DST in 82 patients with mood disorders and 28 controls. There was a close correlation between the cortisol responses on the two tests (r(s)=0.73, p<0.0005). However, ROC analysis revealed that the dex/CRH test had better diagnostic performance than the DST (p=0.031). The sensitivity of delta cortisol (from the dex/CRH) was 61.9% and the specificity 71.4%. The sensitivity of 1500 h cortisol (the DST) was 66.6% and the specificity was 47.6%. This suggests that the two tests measure common pathology but that the dex/CRH test has better diagnostic utility.

Authors+Show Affiliations

School of Neurology, Neurobiology and Psychiatry, The Stanley Research Centre, University of Newcastle upon Tyne, Leazes Wing (Psychiatry), Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK. stuart.watson@ncl.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16701957

Citation

Watson, Stuart, et al. "The dex/CRH Test--is It Better Than the DST?" Psychoneuroendocrinology, vol. 31, no. 7, 2006, pp. 889-94.
Watson S, Gallagher P, Smith MS, et al. The dex/CRH test--is it better than the DST? Psychoneuroendocrinology. 2006;31(7):889-94.
Watson, S., Gallagher, P., Smith, M. S., Ferrier, I. N., & Young, A. H. (2006). The dex/CRH test--is it better than the DST? Psychoneuroendocrinology, 31(7), 889-94.
Watson S, et al. The dex/CRH Test--is It Better Than the DST. Psychoneuroendocrinology. 2006;31(7):889-94. PubMed PMID: 16701957.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The dex/CRH test--is it better than the DST? AU - Watson,Stuart, AU - Gallagher,Peter, AU - Smith,Margaret S, AU - Ferrier,I Nicol, AU - Young,Allan H, Y1 - 2006/05/15/ PY - 2005/10/27/received PY - 2006/02/15/revised PY - 2006/03/01/accepted PY - 2006/5/17/pubmed PY - 2006/9/29/medline PY - 2006/5/17/entrez SP - 889 EP - 94 JF - Psychoneuroendocrinology JO - Psychoneuroendocrinology VL - 31 IS - 7 N2 - The dexamethasone suppression test (DST), frequently abnormal in mood disorder patients, is considered to measure glucocorticoid receptor-mediated negative feedback. We examined the hypothesis that the, apparently more sensitive, dexamethasone/corticotrophin-releasing-hormone (dex/CRH) test unveils subtle hypothalamic-pituitary-adrenal axis disturbance not detected by the DST in 82 patients with mood disorders and 28 controls. There was a close correlation between the cortisol responses on the two tests (r(s)=0.73, p<0.0005). However, ROC analysis revealed that the dex/CRH test had better diagnostic performance than the DST (p=0.031). The sensitivity of delta cortisol (from the dex/CRH) was 61.9% and the specificity 71.4%. The sensitivity of 1500 h cortisol (the DST) was 66.6% and the specificity was 47.6%. This suggests that the two tests measure common pathology but that the dex/CRH test has better diagnostic utility. SN - 0306-4530 UR - https://www.unboundmedicine.com/medline/citation/16701957/The_dex/CRH_test__is_it_better_than_the_DST L2 - https://linkinghub.elsevier.com/retrieve/pii/S0306-4530(06)00050-3 DB - PRIME DP - Unbound Medicine ER -