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Persistent bipolar illness after steroid administration.

R Pies

    Archives of Internal Medicine
    |July 1, 1981
    PubMed
    Summary

    Corticosteroids used for ulcerative colitis triggered persistent bipolar illness, including mania and depression, in a young woman. This case highlights a potential long-term psychiatric risk associated with steroid treatment.

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    Area of Science:

    • Psychiatry
    • Endocrinology
    • Gastroenterology

    Background:

    • Ulcerative colitis is an inflammatory bowel disease.
    • Corticosteroids are commonly used to manage ulcerative colitis flares.

    Observation:

    • A 28-year-old woman developed depression and mania after a single course of corticosteroids for ulcerative colitis.
    • These mood disturbances persisted for 1.5 years, with recurrent episodes of mania and depression despite steroid discontinuation.

    Findings:

    • This case presents the first documented instance of persistent bipolar illness following exogenous steroid administration.
    • The patient experienced cyclical mood episodes suggestive of bipolar disorder.

    Implications:

    • Exogenous corticosteroids may induce long-term mood disorders, including bipolar illness.
    • Further research is needed to understand the neurobiological mechanisms linking steroid exposure and persistent mood disturbances.
    • Clinicians should monitor for psychiatric side effects in patients treated with corticosteroids, particularly for prolonged periods.

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