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B. Timothy Walsh, MD; Ee Sing Lo, PhD; Thomas Cooper, MA; David C. Lindy, MD; Steven P. Roose, MD; Madeline Gladis, MA; Alexander H. Glassman, MD

Arch Gen Psychiatry. 1987;44(9):797-800.

Abstract
• A 1-mg dexamethasone suppression test (DST) was carried out in 66 women with bulimia and in 26 age- and sexmatched controls. Blood samples were obtained at 4 PM on the day following dexamethasone ingestion, and levels of cortisol and of dexamethasone in the plasma were measured. Thirtytwo percent of the patients vs only 7% of the controls had plasma cortisol levels of 140 nmol/L (5 µ/dL) or greater following the DST (a positive DST). The plasma levels of dexamethasone varied substantially, and there was a significant inverse relationship between the plasma level of cortisol and that of dexamethasone. Patients with positive DST results had lower levels of plasma dexamethasone than did those with negative DST results, and the mean plasma level of dexamethasone was lower in the bulimic group than in the control group. These results suggest that factors other than a disturbance of hypothalamic-pituitary-adrenal activity may contribute to positive DST results in bulimia.

Author Affiliations
From the Department of Psychiatry, College of Physicians and Surgeons, Columbia University, and the New York State Psychiatric Institute, New York.

Footnotes
Accepted for publication July 11, 1986.

Reprint requests to New York State Psychiatric Institute, 722 W 168th St, New York, NY 10032 (Dr Walsh).

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