Weight Loss and the Dexamethasone Suppression Test

To the Editor.— Recent reports have suggested that the dexamethasone suppression test (DST) is not specific for melancholia. 1-3 Concerned by the relatively poor correlation between DST results and the clinical diagnosis of melancholia among our hospitalized depressed patients, we hypothesized that perhaps an intervening variable might account for nonsuppression on the DST and an apparent relationship with melancholia. Since weight loss is both a physiologic stressor and a creterion for DSM-III -diagnosed melancholia, we investigated the relationship between weight loss and DST results among depressed inpatients. We retrospectively reviewed the medical records of 27 patients hospitalized for depression for whom DST results were available. Charts were examined for notations of direction and magnitude of weight change in the period immediately preceding hospitalization. None of the patients was cachectic, and none had lost 10% or more of his normal weight. None had major physical illness, recent steroid ingestion, or other