Development of obsessive-compulsive behaviour following cortisone treatment

Area of Science:

• Neuroscience
• Psychiatry
• Pharmacology

Background:

• Pulmonary disease management often involves oral corticosteroid therapy.
• Obsessive-compulsive behaviors (OCB) are typically associated with other psychiatric conditions or neurological disorders.
• The potential for corticosteroids to induce psychiatric symptoms is recognized, but OCB is rarely reported.

Observation:

• A 75-year-old male patient with pulmonary disease developed new-onset obsessive-compulsive behaviors.
• The patient had no prior history of psychiatric symptoms or diagnosed organic brain disorder.
• The behavioral changes emerged during treatment with oral corticosteroids.

Findings:

• This report details the first documented case of obsessive-compulsive behavior directly linked to oral corticosteroid administration.
• The patient's pulmonary condition and lack of pre-existing psychiatric history make this a unique presentation.
• Clinical and pathophysiological mechanisms underlying corticosteroid-induced OCB are explored.

Implications:

• This case suggests that oral corticosteroids may be an underrecognized trigger for obsessive-compulsive behaviors.
• Clinicians should monitor for new-onset psychiatric symptoms, including OCB, in patients receiving oral corticosteroids.
• Further research is warranted to elucidate the neurobiological pathways involved in this adverse drug reaction.