• dexamethasone;
  • cortisol;
  • depression;
  • gender;
  • menopause;
  • carbamazepine

Objective:  Previous studies show a state-dependent relationship between depression and post-dexamethasone suppression test (DST) cortisol level, as well as differences in DST response with age and gender.

Method:  In this study, 74 research in-patients with affective disorders were given the DST on placebo and in a subgroup following treatment with carbamazepine. Depression was evaluated twice daily with the Bunney–Hamburg (BH) rating scale. Data were examined for the total subject population, by gender and by menopausal status in women.

Results:  A robust positive correlation was observed between depression severity and post-DST cortisol in pre- and postmenopausal females, but not in males. This relationship persisted in women when restudied on a stable dose of carbamazepine (n=42).

Conclusion:  The pathophysiological implications of this selective positive relationship between severity of depression and post-DST cortisol in women, but not men, should be explored further.