Document Detail

Recurrent cases of corticosteroid-induced mood disorder: clinical characteristics and treatment.
MedLine Citation:
PMID:  10830146     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Corticosteroids often induce steroid psychosis, a collection of heterogeneous syndromes with different pathophysiologic mechanisms. To date, no study has focused specifically on recurrent corticosteroid-induced mood disorders and considered their long-term outcome and treatment strategies. METHOD: Nine patients whose initial clinical presentation met DSM-IV criteria for a substance-induced mood disorder were identified by a review of medical records. Their clinical characteristics and treatments were examined. RESULTS: All 9 corticosteroid-treated patients had a clinical course of bipolar disorder. Seven patients initially developed a manic or hypomanic state with subacute onset ranging from 1 to 3 months. Six patients had manic episodes accompanied by psychotic features. The proportion of manic episodes relative to total mood episodes of the 9 patients was 65.6%, suggesting manic predominance. Seven patients showed mood episodes that had no direct relationship to corticosteroid therapy and were preceded by various psychosocial stressors. Four of 5 patients who received steroid pulse therapy rapidly became manic or hypomanic. Antidepressants as well as mood stabilizers were useful for treatment of the present 9 patients. CONCLUSION: Recurrent cases of corticosteroid-induced mood disorder have interesting clinical features, such as subacute onset, manic predominance, frequent accompanying psychotic features, and similar recurrent episodes in association with psychosocial stressors and corticosteroid use. Management, including psychopharmacologic intervention, should be indicated by a consideration of the underlying illnesses and psychosocial stressors.
K Wada; N Yamada; H Suzuki; Y Lee; S Kuroda
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of clinical psychiatry     Volume:  61     ISSN:  0160-6689     ISO Abbreviation:  J Clin Psychiatry     Publication Date:  2000 Apr 
Date Detail:
Created Date:  2000-06-02     Completed Date:  2000-06-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7801243     Medline TA:  J Clin Psychiatry     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  261-7     Citation Subset:  IM    
Department of Neuropsychiatry, Okayama University Medical School, Japan.
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MeSH Terms
Adrenal Cortex Hormones / adverse effects*
Anticonvulsants / therapeutic use
Antidepressive Agents / therapeutic use
Antipsychotic Agents / therapeutic use
Bipolar Disorder / chemically induced,  diagnosis,  drug therapy
Depressive Disorder / chemically induced,  diagnosis,  drug therapy
Lithium / therapeutic use
Methylprednisolone / administration & dosage,  adverse effects
Middle Aged
Mood Disorders / chemically induced*,  diagnosis,  drug therapy
Pulse Therapy, Drug
Referral and Consultation
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Anticonvulsants; 0/Antidepressive Agents; 0/Antipsychotic Agents; 7439-93-2/Lithium; 83-43-2/Methylprednisolone
Comment In:
J Clin Psychiatry. 2001 Jan;62(1):57-8   [PMID:  11235931 ]

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