The dexamethasone suppression test in inpatients with panic disorder or agoraphobia with panic attacks.

The hypothalamic-pituitary-adrenal (HPA) axis has been meticulously investigated in psychiatric illness, particularly in depression (Sachar et al. 1973; Sachar 1975). The Dexamethasone Suppression Test (DST) as a measure of the integrity of inhibitory feedback loops (Carroll et al. 1981; Stokes et al. 1984; Arana et al. 1985) of the HPA axis has received much attention. Though some controversy remains (Arana et al. 1985), there appears to be a general consensus that moderate to severe major depressive disorder (MDD), particularly in older inpatients, will lead to disinhibition of the HPA axis in a significant number of patients. On tbe other hand, the DST in patients with panic attacks (PA)-panic disorder (PD) and agoraphobia-has consistently yielded suppression in a