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Low-Dose Dexamethasone Suppression Test in Chronic Fatigue Syndrome and Health

Gaab, Jens PhD; Hüster, Dominik MSc; Peisen, Renate MSc; Engert, Veronika BSc; Schad, Tanja BSc; Schürmeyer, Thomas H. PhD, and; Ehlert, Ulrike PhD

Original Articles

Objective: Subtle dysregulations of the hypothalamus-pituitary-adrenal axis in chronic fatigue syndrome have been described. The aim of this study was to examine the negative feedback regulations of the hypothalamus-pituitary-adrenal axis in chronic fatigue syndrome.

Methods: In 21 patients with chronic fatigue syndrome and 21 healthy control subjects, awakening and circadian salivary free cortisol profiles were assessed over 2 consecutive days and compared with awakening and circadian salivary free cortisol profiles after administration of 0.5 mg of dexamethasone at 11:00 PM the previous day.

Results: Patients with chronic fatigue syndrome had normal salivary free cortisol profiles but showed enhanced and prolonged suppression of salivary free cortisol after the administration of 0.5 mg of dexamethasone in comparison to the control subjects.

Conclusions: Enhanced negative feedback of the hypothalamus-pituitary-adrenal axis could be a plausible explanation for the previously described alterations in hypothalamus-pituitary-adrenal axis functioning in chronic fatigue syndrome. Because similar changes have been described in stress-related disorders, a putative role of stress in the pathogenesis of the enhanced feedback is possible.

From the Center for Psychobiological and Psychosomatic Research, University of Trier, Trier, Germany.

Address reprint requests to: Jens Gaab, PhD, Institute of Psychology, Clinical Psychology II, University of Zürich, Zürichbergstr. 43, CH-8044 Zürich, Switzerland. Email: jgaab@klipsy.unizh.ch

Received for publication January 16, 2001; revision received May 21, 2001.

Copyright © 2002 by American Psychosomatic Society
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