The Use of the Dexamethasone Suppression Test in the Differential Diagnosis of Catatonic Stupor

Abstract

Catatonic stupor is a cluster of symptoms and not necessarily a disease entity. It may be seen not only in schizophrenia, but in major affective disorders, conversion disorders, organic brain syndromes, and atypical psychoses. The dexamethasone suppression test is a valuable tool in the diagnosis of major affective disorders, differentiating them from other types of psychopathology. In a twelve month retrospective study, five patients admitted to Psychiatric Institute of Atlanta were identified as meeting the criteria for catatonic schizophrenia. A dexamethasone suppression test was performed shortly after admission. Four of the five had patterns of inadequate suppression, indicative of a major affective disorder rather than a schizophrenic disorder. The dexamethasone suppression test is simple to administer, relatively painless, free from hazards, easy to interpret, readily available, and reliable. Not only can the dexamethasone suppression test be used in diagnosis, but also as a valuable aid in following the therapeutic progress in resolution of a major affective disorder.