强迫症与抑郁障碍、焦虑障碍地塞米松抑制试验对照研究

目的研究地塞米松抑制试验(DST)在强迫症发病机制中的作用及其对强迫症诊断的价值。方法采用放射免疫测定法测定了29例强迫症(OCD)、27例正常对照(NC)、20例抑郁障碍对照(DD)和17例焦虑障碍对照者(AD)DST皮质醇含量结果OCD患者DST阳性率为24.1%,与各对照组比较无显著性差异(P>0.05);OCD患者8:00血浆基础皮质醇浓度显著高于正常对照组(P<0.01);DST阳性的7例OCD患者中6例(85.7%)为男性。结论OCD中存在一组患者DST脱抑制、下丘脑垂体-肾上腺轴活动过度,该结果独立于抑郁;DST对OCD的诊断作用较小。

A Study of Dexamethasone Suppression Test in Patients with Obsessive-Compulsive Disorder

Objective To explore the role of dexamethasone suppression test(DST) in the pathophysiological mechanism of obsessive-compulsive disorder(OCD) and its diagnostic value. Methods The cortisol levels of 29 OCD patients,27 normal controls,20 controls of depressive disorder and 17 controls of anxiety disorder were determined with radioimmunoassay. Results 24.1% of the OCD patients had abnormal DSTs, with no significant differences between the OCD group and each control group (P>0.05).The plasma basal cortisol level of 8AM was significantly lower in the OCD group than the normal controls(P<0.01). Among the 7 OCD patients who escaped suppression, 6 (85.7%) were male. Conclusion There is a subgroup of OCD patients who have abnormal DSTs and have hyper-activity with HPA axis independent of depression.The diagnostic value of DST is low in OCD.