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ABSTRACT
RESUME
The dexamethasone supression test (DST) has proved a useful tool in the diagnosis of endogenous
depression (Carrot et al., 1981). Relying on the above,
it appeared of interest to study the response of schizophrenic patients suffering of TD to the DST. It further justified the performance of our study that
Rosenbaum et al. (1979) reported to have found elevated or upper normal urinary free cortisol (UFC)
levels in 15 of their 18 TD patients.
Since we supposed and occasional common pathomechanism of the affective psychosis and TD based
on data mentioned above, we wanted to avoid the
participation of depressed patients with TD in the present study. Namely in case of finding DST positivity,
The DST was performed in 20 chronic schizophrenic patients diagnosed on the basis of RDC, suffering of TD, and in 20 chronic schizophrenics without
TD. We considered patients having TD if they achived at least one 3, or three 2 on the first seven items
of Abnormal Involuntary Movement Scale (Guy,
1976) at two ratings carried out at intervals of one
month. According to the ward psychiatrist the
patients'movement disorder had been present for at
least two years. The mean age of TD patients was
55,23 6,31 years (mean SD),. that of the patients
without TD was 51,42 8,9 years. The difference
between the mean age of the two groups. The difference between the mean age of the two groups was
statistically nonsignificant (t = 0,701, two tailed, df
= 38, p < 0,5). The mean duration of neuroleptic
treatment for the TD patients was 8,31 2,32 years,
for the patients without TD it was 7,12 4,85 years.
The difference is statistically nonsignificant (t = 0,412,
two tailed, df = 38, p < 0,7). None of the patients
was taking antidepressants during the study, but all were
on neuroleptics. Every patient was female inpatient.
The DST procedure was as follows : the patients
took an oral dose of 1 mg dexamethasone tablet at
10.00 p.m. and post-dexamethasone blood samples
were obtained on the following day at 8.00 a.m. and
3.00 p.m. The criterion of an abnormal DST response
was a higher than 5.00 microgram/dl postdexamethasone cortisol level. Plasma cortisol levels
were measured by a competitive protein binding
method described by Carrol et al. (1981). We had to
depart from the sampling times indicated byCarrol
et al. (1981) for technical reasons.
Every patients was able and willing to give informes consent.
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RESULTS
The mean of the plasma cortisol levels measured
at 8.00 a.m.. in the TD group was 2,39 3,13 microgram/di, that of the group without TD was 2,83
4,35 microgram/dl. The difference was statistically
nonsignificant (t = 0,367, two tailed, df = 38, p <
0,8). The mean plasma cortisol levels in the TD group
at 3.00 p.m. were 1,99 3,54 microgram/dl and 2,65
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Spitzer R.L.. Endicott J., Robins E. - E. Research Diagnostic Criteria/RDC/for a selected group of functional disorders.
3rd edition, Biometric Research, NY State Psychiatric Institute,
New-York,/1977/.
Sternbach H., Gwirtsman H., Gerner R.H. - The dexamethasone suppression test and response to methylphenidate in depression. Am. J. Psychiat. 1981, 138 : 1629-1631.
L'INFORMATION PSYCHIATRIQUE
Sommaire n 8/1984
CORPS ET PSYCHOPATHOLOGIE
DE L'ENFANT
Nurnero special sous Ia direction de R. Mises
Fonctions du Moi-Peau
par D. Anzieu
Corps a corps ou tete a corps
par S. Lebovici
Corps et psychopathologie de ('adolescent
par R. Mises
L'expression corporelle dans Ia psychopathologie de l'enfant
par L. Kreisler
Le corps en question dans deux traitements analytiques d'enfants
par C. Druon
Des corps a constituer
Histoire de Ia psychiatrie
La Guerre par B. Bonfils
Documents administratifs
Analyses de livres
Communiqus
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