Dexamethasone Suppression Test Findings in Subjects With Personality Disorders: Associations With Posttraumatic Stress Disorder and Major Depression

OBJECTIVE: Previous studies using the 1.0-mg dexamethasone suppression test (DST) in subjects with personality disorders have produced mixed results. However, these studies focused on major depression and did not consider the possible effects of the comorbidity of posttraumatic stress disorder (PTSD...

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Bibliographic Details
Published in:The American journal of psychiatry 2003-07, Vol.160 (7), p.1291-1298
Main Authors: Grossman, Robert, Yehuda, Rachel, New, Antonia, Schmeidler, James, Silverman, Jeremy, Mitropoulou, Vivian, Sta. Maria, Nelly, Golier, Julia, Siever, Larry
Format: Article
Language:English
Subjects:
Adult
Adult and adolescent clinical studies
Age Factors
Behavior disorders
Biological and medical sciences
Borderline Personality Disorder - blood
Borderline Personality Disorder - diagnosis
Borderline Personality Disorder - epidemiology
Comorbidity
Depressive Disorder - blood
Depressive Disorder - diagnosis
Depressive Disorder - epidemiology
Dexamethasone
Female
Humans
Hydrocortisone - blood
Life Change Events
Male
Medical sciences
Mental depression
Personality disorders
Personality Disorders - blood
Personality Disorders - diagnosis
Personality Disorders - epidemiology
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Stress
Stress Disorders, Post-Traumatic - blood
Stress Disorders, Post-Traumatic - diagnosis
Stress Disorders, Post-Traumatic - epidemiology
Surveys and Questionnaires
Tests
Citations: Items that cite this one
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Summary:OBJECTIVE: Previous studies using the 1.0-mg dexamethasone suppression test (DST) in subjects with personality disorders have produced mixed results. However, these studies focused on major depression and did not consider the possible effects of the comorbidity of posttraumatic stress disorder (PTSD). PTSD has been shown to be associated with increased cortisol suppression. To investigate the effect of PTSD, the authors conducted a 0.5-mg DST, which is more sensitive than the 1.0-mg DST for detection of increased cortisol suppression, in a group of subjects with personality disorders. METHOD: Subjects with personality disorders (N=52) ingested 0.5 mg of dexamethasone. Pre- and postfasting blood samples were drawn for measurement of cortisol levels. A three-way analysis of covariance was used to test for the main effects of major depression, PTSD, and gender on percent cortisol suppression, with plasma dexamethasone concentration as a covariate. Secondary analyses assessed for main and interaction effects of age at which trauma(s) occurred and a diagnosis of borderline personality disorder. RESULTS: Neither major depression nor gender had a significant effect on percent cortisol suppression. Subjects with PTSD had significantly higher percent cortisol suppression than subjects with major depression. Age at which trauma(s) occurred and a borderline personality disorder diagnosis had no significant main or interaction effects on cortisol suppression. CONCLUSIONS: A high level of cortisol suppression was associated with PTSD in subjects with personality disorder. This finding is similar to published findings for PTSD subjects without personality disorders. Major depression, gender, age when trauma(s) occurred, and a diagnosis of borderline personality disorder did not have significant main or interaction effects on cortisol suppression.
ISSN:0002-953X
1535-7228
DOI:10.1176/appi.ajp.160.7.1291