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Related Experiment Videos

Psychiatric Symptoms Associated with Corticosteroid Use: A Systematic Review and Meta-analysis.

Keisuke Kusudo1,2, Yuki Mashima1, Hideaki Yasuda3

  • 1Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.

CNS Drugs
|June 28, 2026
PubMed
Summary

Corticosteroid use is linked to increased depressive and manic symptoms, particularly early in treatment. Monitoring mood changes is crucial, especially for high-dose or older patients.

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Area of Science:

  • Psychiatry
  • Pharmacology
  • Systematic Reviews

Background:

  • Corticosteroids (CSs) are frequently prescribed medications.
  • CS use is associated with various psychiatric adverse effects, including depression, mania, psychosis, and anxiety.
  • The precise association and influencing factors require further elucidation.

Purpose of the Study:

  • To systematically review and meta-analyze the association between corticosteroid use and psychiatric symptoms.
  • To quantify the risk of depressive, manic, psychotic, and anxiety symptoms in CS users.
  • To explore potential moderators, such as dose, duration, age, and sex, influencing these associations.

Main Methods:

  • A PRISMA-guided systematic review and meta-analysis of observational studies.
  • Searches of MEDLINE and Embase databases, supplemented by hand-searched records.
  • Inclusion of studies on medical CS users, excluding specific populations and study designs; risk of bias and certainty of evidence assessed using Newcastle-Ottawa Scale and GRADE.

Main Results:

  • CS use was associated with significantly higher depressive symptom scores (SMD = 0.92).
  • Manic symptoms were more frequent than depressive symptoms during the acute phase (OR = 2.42).
  • Psychotic symptoms were estimated in 2.4% of CS users; anxiety showed no significant association.

Conclusions:

  • Corticosteroid use is linked to more severe depressive symptoms and potentially manic symptoms during acute treatment.
  • Psychotic reactions are uncommon, but routine monitoring for mood and psychotic changes is recommended.
  • Higher dose and older age may modulate depressive severity, warranting cautious interpretation and clinical vigilance.