Abstract
IntroductionCorticosteroids may induce psychiatric symptoms (agitation, fear, hypomania, insomnia, irritability, labile mood, pressured speech and restlessness) with incidence rates ranging from 1,8% to 57%. We present a case of corticosteroid-induced mania and psychosis.ObjectivesNon-systematic review on corticosteroid therapy induced psychiatric symptoms. Analysis and comparison of a patient’s case with the existing literature.MethodsCase report and a non-systematic review through databases as Pubmed, UpToDate, Medscape, between 2000 and 2020.ResultsWe present a female 70 year-old patient without psychiatric background, diagnosed with Rhizomelic Pseudopolyarthritis, who started treatment with prednisone 20 mg. During the third month of treatment the patient started progressively worse behavior changes (such as destruction of the neighbor’s property), developed persecutory delusions, decreased sleep and increased energy. The patient was committed to our psychiatric ward and started on diazepam 10 mg and olanzapine 15 mg per day. Despite introduction of antipsychotics, which has evidence for mood stabilization, the patient maintained the symptoms, so it was necessary to gradually reduce corticosteroids until symptomatic control.ConclusionsPsychosis (24%), hypomania and mania (35%), are the most common psychiatric reactions to corticosteroid therapy. Several studies show that even a low dosage may induce psychiatric disturbances, most frequently during the first two weeks of treatment. However, as reported in this case, symptoms may occur at any time. Thus, a multidisciplinary team, as well as training of professionals from different specialties, such as psychiatry, rheumatology and endocrinology, are needed, since these syndromes may be confused with pure psychiatric conditions and consequently delay treatment and compromise prognosis.DisclosureNo significant relationships.
Highlights
Major depressive disorder (MDD) is complex and multifactorial, posing a major challenge of tailoring the optimal medication for each patient
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Summary
The literature shows a high prevalence of psychopathological problems, anxiety and depression among university students because of academic expectations, uncertain future plans, staying away from their family, economic issues and peer relationships. These problems show high prevalence among university students, providing them a professional care is limited so most of problems remain untreated. Objectives: The intent of the study was to review systematically the impacts of web based and computer delivered interventions regarding stress management among university students. All results of reviewed articles show that web based online interventions have an impact to reduce depression, stress and anxiety level among students. In addition online interventions regarding stress management may provide us to reach out large group of university students
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