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Predicting the Response of Depressed Patients to Biological Treatment: the Dexamethasone Suppression Test Versus Clinical Judgement

A dexamethasone suppression test (DST) was carried out in a heterogeneous sample of 174 depressed patients. In a subsample of 130 patients in whom biological antidepressive treatment had been commenced either because of an initial clinical judgement of ‘endogenicity’ or because of subsequent evidence of DST non-suppression, the response to treatment was globally assessed. The results showed no significant differences between the two groups in the numbers of patients responding favourably to treatment. The positive predictive value of DST non-suppression for a favourable response was no higher than that of clinical judgement, and there was little difference between the sensitivity and specificity of the two predictors.