[Psychiatric complications of glucocorticoid treatment]

In the article, clinical symptoms of psychiatric complications occurring during treatment with glucocorticoids were described, and therapeutic guidelines were suggested. Psychiatric symptoms are observed in approximately 25% of patients receiving glucocorticoid therapy. Depression, mania and mixed states are the most frequent, psychotic symptoms and cognitive impairments (including delirium) are but less frequent. Associations between clinical factors (i.e. age, sex, past psychiatric story, medical condition, the dose of glucocorticoids) and the frequency and the severity of psychiatric complications were discussed. When psychiatric disturbances occur, the reduction or discontinuation of glucocorticoids should be taken into account. Treatment of psychiatric symptoms is needed when psychiatric disorder is severe or the patient is suicidal or agitated. In such cases the use of neuroleptics, antidepressants, normothymic and other drugs, as well as electroconvulsive therapy was discussed. The outcome is generally good, the majority of patients make a good recovery, over 90% of patients restored to health within 6 weeks of the onset of treatment.