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The dexamethasone suppression test in bulimic outpatients without major depression

Published online by Cambridge University Press:  16 April 2020

D Bailly*
Affiliation:
Psychopathology and Alcohology Unit, University Hospital, Hôpital de La Charité, 196 Bd Montebello, 59037Lille Cedex, France
N Regnaut
Affiliation:
Psychopathology and Alcohology Unit, University Hospital, Hôpital de La Charité, 196 Bd Montebello, 59037Lille Cedex, France
PJ Parquet*
Affiliation:
Psychopathology and Alcohology Unit, University Hospital, Hôpital de La Charité, 196 Bd Montebello, 59037Lille Cedex, France
*
*Members of the INSERM Institute no 489014 on the behaviour of bulimics
*Members of the INSERM Institute no 489014 on the behaviour of bulimics
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Summary

Recent studies have examined the effectiveness of the dexamethasone suppression test (DST) in the evaluation of bulimia. In a series of 18 female bulimic outpatients without major depression, 9 (50%) failed to suppress on the DST. No significant difference was found between suppressors and nonsuppressors in personal and family histories of affective disorder, levels of anxious and depressive symptoms, psychoactive substance abuse, and severity of abnormal eating-related behaviours. In contrast, non-suppression was significantly associated with low weight. There is a trend to differentiate non-suppressors from suppressors in the current diagnosis of anorexia nervosa and in past history of anorexia nervosa. Seven patients received fluvoxamine for 8 weeks. Five patients were suppressors and showed a significant decrease in the frequency of their binges while the 2 non-suppressors did not improve. These preliminary results suggest that DST non-suppression might be typical of bulimic patients with anorexia nervosa and that pretreatment DST results might predict the response of bulimic behaviour to treatment with fluvoxamine.

Type
Original article
Copyright
Copyright © Elsevier, Paris 1992

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References

Bailly, DGeorget, OHoudret, NLhermitte, MDervaux, AParquet Ph, J (1990) Alcoholism and drug abuse: sociodemographic and toxicologic data Sem Hôp Paris 66, 24482454Google Scholar
Berger, MPirke, KMKrieg, JCVon Zerssen, D (1985) The effect of weight loss and inappropriate plasma dexamethasone levels on the DST Psychiatry Res 15, 351360CrossRefGoogle ScholarPubMed
Carroll, BJFeinberg, MGreden, JFTarika, JAlbala, AAHaskett, RFJames, NMcIKronfol, ZLohr, NSteiner, Mde Vigne, JPYoung, E (1981) A specific laboratory test for the diagnosis of melancholia: standardization, validation, and clinical utility Arch Gen Psychiatry 38, 1522CrossRefGoogle Scholar
Edelstein, CKRoy-Byrne, PFawzy, FIDornfeld, L (1983) Effects of weight loss on the dexamethasone suppression test Am J Psychiatry 140, 338341Google ScholarPubMed
Fichter, MMPirke, KMHolsboer, F (1986) Weight loss causes neuroendocrine disturbances: experimental study in healthy starving subjects Psychiatry Res 17, 6172CrossRefGoogle ScholarPubMed
Freeman, CPLHampson, M (1987) Fluoxetine as a treatment for bulimia nervosa Int J Obesity (suppl 3) 11, 171177Google ScholarPubMed
Gerner, RHGwirtsman, HE (1981) Abnormalities of dexamethasone suppression test and urinary MHPG in anorexia nervosa Am J Psychiatry 138, 650653Google ScholarPubMed
Gwirtsman, HERoy-Byrne, PYager, J (1983) Neuroendocrine abnormalities in bulimia Am J Psychiatry 140, 559563Google ScholarPubMed
Hudson, JIHudson, MS (1984) Endocrine dysfunction in anorexia nervosa and bulimia: comparison with abnormalities in other psychiatric disorders and disturbances due to metabolic factors Psychiatr Dev 4, 237272Google Scholar
Hudson, JILaffer, PSPope, HG Jr (1982) Bulimia related to affective disorder by family history and response to the dexamethasone suppression test Am J Psychiatry 139, 685687Google ScholarPubMed
Hughes, PLWells, LACunningham, CJ (1986) The dexamethasone suppression test in bulimia before and after successful treatment with desipramine J Clin Psychiatry 47, 515517Google ScholarPubMed
Kline, MDBeeber, AL (1983) Weight loss and the dexamethasone suppression test (letter) Arch Gen Psychiatry 40, 10341035CrossRefGoogle Scholar
Levy, ABDixon, KN (1987) DST in bulimia without endogenous depression Biol Psychiatry 22, 783786CrossRefGoogle ScholarPubMed
Mitchell, JEPyle, RLHatsukami, DBoutacoff, LI (1984) The dexamethasone suppression test in patients with bulimia J Clin Psychiatry 45, 508511Google ScholarPubMed
Nemeroff, CBEvans, DL (1984) Correlation between the dexamethasone suppression test in depressed patients and clinical response Am J Psychiatry 141, 247249Google ScholarPubMed
Perez, ELBlouin, JBlouin, A (1988) The dexamethasone suppression test in bulimia: nonsuppression associated with depression and suboptimal weight J Clin Psychiatry 49, 9496Google ScholarPubMed
Pope, HG JrHudson, JI (1986) Antidepressant drug therapy for bulimia: current status J Clin Psychiatry 47, 339345Google ScholarPubMed
Rosenbaum, AHSchatzberg, AFMac Laughlin, RASnyder, KJiang, NSIlstrup, DRothschild, AJKliman, B (1984) The dexamethasone suppression test in normal control subjects: comparison of two assays and effect of age Am J Psychiatry 141, 15501555Google ScholarPubMed
Roy-Byrne, PGwirtsman, HEYager, J (1982) Neuroendocrine tests in bulimia. Presented at the annual meeting of the American Psychiatric Association, TorontoGoogle Scholar
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