The utility of the dexamethasone suppression test (DST( n the diagnosis of depression were examined in 38 stroke inpatients. The depressive symptoms were assessed by the modified Hamilton depression rating scales.
@ES The results ere as follows:
@EN 1) The patients with abnormal DST had significantly higher Hamilton scales (13~15) than those with normal DST (8~9).
2) Defining the depression as above 14 pints of Hamilton scales, the sensitivity, specificity and positive predictive value (PPV) of the DST were in the following order: 69.2~78.6%, 79.2~87.5% and 66.7~76.9%.
3) Three patients with false positive DST were all within one month after the stroke.
4) The specificity and PPV of the DST were in the following order: DSTL (DST in which the lower cortisol value between the 8AM and 4PM cortisol value was selected)-87.5%, 76.9%; DST8AM (DST in which the 8AM cortisol value was selected)-87.0%,
75.0%;
DST4PM (DST in which the 4PM cortisol value was selected)-82.6%, 66.7%.
5) Abnormal DST or Hamiiton scales representing depression were not correlated with the nature, site or size of the brain lesion.
The results demonstrate that the DST is a useful specific indicator of depression in patients with stroke, and it is necessary to rule out the false positivity, especially in acute phase.
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