Sirois François
Department of Psychiatry, Hôpital Laval, Sainte-Foy, Québec, Canada. fsir@globetrotter,net
Gen Hosp Psychiatry. 2003 Jan-Feb;25(1):27-33. doi: 10.1016/s0163-8343(02)00241-4.
This review is built upon a time-framed perspective to unfold the growth of evidence and the shifting of focus from primary affective short-term reactions to later findings of cognitive deficits and possible permanent impairment linked to steroid treatment. An incidence related to dosage has been documented and delirium and withdrawal symptoms have been reported in later studies. A hypothesis of sensitization process with multiple course of steroids has been proposed with the reporting of recurrent cases. The issue of individual risk appears unsettled while management of psychiatric reactions to steroids has shifted toward prophylactic use of lithium.
本综述基于时间框架视角,以展现证据的增长以及关注点从最初的情感短期反应转向与类固醇治疗相关的认知缺陷及可能的永久性损害的后期研究结果。与剂量相关的发病率已有记录,后期研究中也报告了谵妄和戒断症状。随着复发病例的报告,有人提出了类固醇多疗程致敏过程的假说。个体风险问题似乎尚未解决,而对类固醇精神反应的管理已转向预防性使用锂盐。