Dexamethasone suppression test using saliva cortisol measurement in bulimia nervosa

The assessment of cortisol in saliva has been proven a valid and reliable r eflection of the respective unbound hormone in blood. In the present study, a standard dexamethasone suppression test (DST) with measures of salivary cortisol levels was performed in bulimic women without depression (DSM-TV; N=48) and healthy controls (N= 24) matched for age. Feedback sensitivity wa s assessed using the standard DST with pre- and post-measures of salivary c ortisol. Subjects were divided into suppressors and nonsuppressors accordin g to their post-DST levels. Bulimic suppressors and nonsuppressors were com pared for their basal cortisol levels, body weight (body mass index, BMI), previous episodes of anorexia nervosa, acid their results in psychometric t ests. A total of 16 (33.3%) out of 48 women with bulimia nervosa CBN) faile d to suppress in the DST. Basal salivary cortisol levels were elevated in b ulimic nonsuppressors. Significant differences between suppressors and nons uppressors were found for body weight and previous episodes of anorexia ner vosa. The results are in accordance with recent findings. They support the hypothesized association between low body weight and DST nonsuppression. Us ing saliva cortisol in the standard DST could be advantageous for studying bulimic patients. Furthermore, the results show the importance of determini ng HPA reagibility when measuring cortisol in bulimic patients. (C) 2001 El sevier Science Inc. All rights reserved.