The authors compare the incidence of dexamethasone nonsuppression in a large group of child and adolescent inpatients (N = 94) diagnosed by two criteria (DSM-III and Weinberg criteria). The incidence of dexamethasone suppression test nonsuppression in patients diagnosed with DSM-III major depressive disorder (n = 33) was 55%, compared to 11% in those with no affective disorder (n = 35). This was compared to the incidence of dexamethasone suppression test nonsuppression utilizing Weinberg criteria. In addition, symptoms that to varying degrees discriminated suppressors from nonsuppressors were examined. These included change in school performance and, to a lesser degree, somatic complaints and weight and appetite changes. Differences in the diagnostic criteria are discussed. (J Child Neurol 1987;2:31-37).
Get full access to this article
View all access options for this article.
References
1.
Poznanski EO , Grossman J., Banegas M., et al: Melancholic and endogenous symptoms in depressed school aged childrenRead before the Annual Meeting of the American Academy of Child Psychiatry , Washington, DC, 1983.
2.
Carlson GA, Cantwell DP: Diagnosis of childhood depression: A comparison of the Weinberg and the DSM-III criteria. J Am Acad Child Psychiatry1982;21:247-250.
3.
Weinberg WA, Rutman J., Sullivan L., et al: Depression in children referred to an educational diagnostic center: diagnosis and treatment. J Pediatr1973;83:1065-1073.
4.
Rush AJ, Giles DE, Roffwarg HP, Parker RC: Sleep EEG and dexamethasone suppression test findings in outpatients with unipolar and major depressive disorders. Biol Psychiatry1982(a);17:327-341.
5.
Akiskal HS : The joint use of clinical and biologic criteria for psychiatric diagnosis. I. A historical and methodological review, in Akiskal HS, Webb WL (eds): Psychiatric Diagnosis: Exploration of Biological Predictors. New York, Spectrum Publications Inc, 1978, pp 103-132.
6.
Brumback RA : Depressive disorder in childhood. Am J Psychiatry1976;133:455.
7.
Spitzer RL , Endicott J., Robins E.: Research diagnostic criteria: rationale and reliability. Arch Gen Psychiatry1978 ;35:773-782.
8.
Feighner JP , Robbins E., Guze SP, et al: Diagnostic criteria for use in psychiatric research. Arch Gen Psychiatry1972;26:57-63.
9.
Weinberg WA , McLean A.: A diagnostic approach to developmental specific learning disorders . J Child Neurol1986;1: 164-165.
10.
Hudgens RW: Psychiatric Disorders in Adolescents. Baltimore , The Williams and Wilkins Co, 1974.
11.
Ling W., Oftedal G., Weinberg WA: Depressive illness in childhood presenting as severe headache. Am J Dis Child1970;120:122-124.
12.
Crytyn L., McKnew DHJr: Proposed classification of childhood depression. Am J Psychiatry1972;129:149-155.
13.
Petti TA: Depression in hospitalized child psychiatry patients: Approaches to measuring depression. J Am Acad Child Psychiatry1978 ;17:49-59.
14.
Puig-Antich J.: The use of RDC criteria for major depressive disorder in children and adolescents. J Am Acad Child Psychiatry1982;21:291-293.
15.
Puig-Antich J. , Gittelman R.: Depression in childhood and adolescence , in Paykel ES (ed): Handbook of Affective Disorders. New York, Gilford Press, 1982.
16.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, ed 3. Washington, DC, American Psychiatric Association, 1980.
17.
Carroll BJ, Curtis GC, Mendels J.: Neuroendocrine regulations in depression. I. Limbic system-adrenocortical dysfunction. Arch Gen Psychiatry1976;33:1039-1044.
18.
Carroll BJ, Curtis GC, Mendels J.: Neuroendocrine regulation in depression. II. Discrimination of depressed from nondepressed patients. Arch Gen Psychiatry1976;33:1051-1057.
19.
Carroll BJ , Greden JF, Feinberg M.: Suicide, neuroendocrine dysfunction and CSF 5-HIAA concentrations in depression , in Angrast B (ed): Recent Advances in Neuropsychopharmacology: Advances in the Biosciences . New York, Pergamon Press Inc , 1981 , vol 31.
20.
Stokes P., Stoll P., Maas J., et al: Dexamethasone suppression test: Clinical utility. History, physiology, clinical utility: An overview, abstractedAmerican Psychiatric Association Syllabus Scientific Proceedings1983 ;35A:100.
21.
Peselow EW, Goldring N., Fieve R., Wright R.: The dexamethasone suppression test in depressed outpatients and normal control subjects. Am J Psychiatry1983;140:245-247.
22.
Angst J.: Zur aetiologic and nosologic endogene depressives psychasen. MonogrNeurol Psychiatry1966;112:1-18.
23.
Schlesser MA , Rush AJ: Serial changes in hypothalamic-pituitary adrenal axis activity among depressed patients receiving ECT. Read before the Society of BiologicalPsychiatry, New Orleans, 1981.
24.
Albala AA, Greden JF: Serial dexamethasone suppression tests (DST) in affective disorders . Am J Psychiatry1980,137:383.
25.
Greden JF, Albala AA, Haskett RF, et al: Normalization of dexamethasone suppression test: A laboratory index of recovery from endogenous depression. Biol Psychiatry1980;15: 449-458.
26.
Goldberg IK : Dexamethasone suppression tests in depression and response to treatment. Lancet1980;2:92.
27.
Coryell W., Schlesser MA: Suicide and the dexamethasone suppression test in unipolar depression . Am J Psychiatry1981;138:1120-1121.
28.
Rush AJ, Schlesser MA, Giles DE, et al: The effect of dosage on the dexamethasone suppression test in normal controls. Psychiatr Res1982;7:277-285.
29.
Poznanski EO , Carroll VJ, Bauagsa ME, et al: The dexamethasone suppression test in prepubertal depressed children. Am J Psychiatry1982;139:321-324.
30.
Weller EB, Weller RA, Furstad MA, Preskorn SH: The dexamethasone suppression test in hospitalized prepubertal depressed children . Am J Psychiatry1984;141:290-291.
31.
Livingston R., Reis CJ, Ringdahl IC: Abnormal dexamethasone suppression test results in depressed and nondepressed children. Am J Psychiatry1984;141:106-108.
32.
Extein I., Rosenberg G., Pottash ALC, Gold MS: The dexamethasone suppression test in depressed adolescents. Am J Psychiatry1982;139:1617-1619.
33.
Robbins DR, Alessi NE, Yanchyshyn GW, Colfer MV: Preliminary report on the dexamethasone suppression test in adolescents . Am J Psychiatry1982;139:942-943.
34.
Ha H., Kaplan S., Foley C.: The dexamethasone suppression test in adolescent psychiatric patients . Am J Psychiatry1984;141: 421-423.
35.
Tanner JM: Growth of Adolescence. Oxford, Blackwell Scientific Publications, 1962.
36.
Brumback RA , Dietz-Schmidt SA, Weinberg WA: Depression in children referred to an Educational Diagnostic Center: Diagnosis and treatment and analysis of criteria and literature review. Dis Nerv Sys1977;38:7:529-535.
37.
Brumback RA , Staton RD: An hypothesis regarding the commonality of right-hemisphere involvement in learning disability, attentional disorder, and childhood major depressive disorder. Percept Mot Skills1982;55:1091-1097.
38.
Brumback RA , Staton RD: Learning disability and childhood depression . Am J Orthopsychiatry1983;53:269-281.
