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Abstract：
Activity of the hypothalamic-pituitary-adrenal axis had been studied for the past half century, when some researchers noted that some patients with Cushing\'s syndrome and severe mood disorders had high baseline cortisol levels, which resulted in an inhibited response in the 1mg dexamethasone suppression test. Altered dexamethasone suppression test results were subsequently found in many psychiatric diseases, including anorexia nervosa, obsessive-compulsive disorder, degenerative dementia, bipolar disorders, and schizophrenia. The relationship between high baseline cortisol levels and stress has also been studied. Some researches on the genesis of borderline personality disorder focused on traumatic childhood backgrounds. Other investigations aimed at elucidating the relationship between traumatic backgrounds and some psychiatric disorders noted that patients with post-traumatic stress disorder and borderline personality disorder showed an enhanced cortisol suppression with low cortisol doses (0.5 mg). Recent studies showed that use of an ultra-low dose of cortisol during the dexamethasone suppression test may be helpful for detecting disorders with hyperactivity of the hypothalamic-pituitary-adrenal axis. Recent advances in neuroimaging support the existence of hyperactivity of the hypothalamic-pituitary-adrenal axis in patients with borderline personality disorder, relating a decreased pituitary gland volume to major traumatic backgrounds and suicidal attempts. The purpose of this paper is to make a narrative review of research using dexamethasone suppression test in psychiatric disorders, in order to ascertain its value as a supplemental diagnostic test or as a prognostic marker.
摘要：
下丘脑-垂体-肾上腺轴的活动已经研究了半个世纪，当一些研究人员注意到一些库欣综合征和严重情绪障碍的患者有较高的基线皮质醇水平，这导致抑制反应在1mg地塞米松抑制试验。随后在许多精神疾病中发现了改变的地塞米松抑制试验结果，包括神经性厌食症,强迫症,退行性痴呆，双相情感障碍,和精神分裂症。还研究了高基线皮质醇水平与压力之间的关系。关于边缘性人格障碍的起源的一些研究集中在儿童时期的创伤背景上。其他旨在阐明创伤背景与某些精神疾病之间关系的研究指出，患有创伤后应激障碍和边缘性人格障碍的患者在皮质醇剂量较低（0.5mg）的情况下表现出增强的皮质醇抑制作用。最近的研究表明，在地塞米松抑制试验中使用超低剂量的皮质醇可能有助于检测下丘脑-垂体-肾上腺轴过度活跃的疾病。神经影像学的最新进展支持边缘性人格障碍患者存在下丘脑-垂体-肾上腺轴的过度活动，脑垂体体积减少与主要创伤背景和自杀企图有关。本文的目的是对使用地塞米松抑制试验在精神疾病中的研究进行叙述性回顾，以确定其作为补充诊断测试或作为预后标志物的价值。
