Steroid-Induced Psychosis in the Pediatric Population: A New Case and Review of the Literature

Abstract

Given the common use of glucocorticoid therapy in children, it is important that physicians and parents recognize the signs of steroid-induced psychosis and are aware of the data on treating this complication.

Steroid Induced Psychosis in a Rare Case of Bronchiolitis Obliterans Organizing Pneumonia

“…In this case, the choice of therapy with valproic acid and risperidone was based on the patient's diagnosis of SLE, which could lead to further complications with other therapies [23]. Further, the patient in this case report contrasts to previous reports indicating the resolution of psychosis achieved when the steroid has been completely stopped [19,23]. Nonetheless it is important to note, for patients receiving high dose or long-term treatment of corticosteroids, corticosteroid withdrawal is a necessary consideration when managing the duration for dose tapering.…”

“…Bronchiolitis obliterans organizing pneumonia (BOOP), also referred to as Epler's pneumonia, is a rare lung disorder with the distinguishing trait of intolerable distress due to other comorbidities [19].…”

“…Corticosteroids are commonly used in the management of pulmonary and autoimmune conditions and the use is carefully considered for patient age, comorbidities, immunocompetency and disease pathology as a side effect of prolonged use can lead to unfavorable results effecting bone growth, changes to hormone levels, further complicated immunosuppression and a wide range of psychiatric side effects, including disturbance of mood cognition, sleep, and behavior, euphoria, hypomania, frank delirium and psychosis. Of these, steroid induced psychosis is an iatrogenic condition predominantly affecting adults and at lower rates in children [17][18][19][20]. The initial recommended intervention for patients presenting with corticosteroid-induced psychosis is cessation of the corticosteroid.…”

Emergence Delirium: Can Corticosteroids Contribute to It?

“…Numerous neuropsychiatric effects were attributed to corticosteroids in the past, but received less attention, unfortunately, than somatic manifestations in the literature. 3,4 As the controlled studies are lacking, the evidence is based on case-series reports. 5 Besides, relationship between corticosteroids and ED has never been discussed in the literature.…”

“…3 Nevertheless, evidence in pediatric population is sparse, with only few cases reported in the literature. 4 The heterogeneous group of mental disturbances attributed to corticosteroids is termed steroid psychosis. Diverse neuropsychiatric symptoms including behavioral, cognitive, and affective syndromes are attributed to corticosteroids.…”