Cornic Françoise, Rousset Inqrid
Service de psychiatrie, secteur 13, hôpital Sainte-Anne, Paris.
Rev Prat. 2008 Mar 15;58(5):469-75.
Glucocorticoids induced psychiatric disorders mostly emerge within the first weeks of corticotherapy. They occur in a variety of qualitatively distinct forms. Manic symptoms are among the most important manifestations of corticosteroids-induced psychiatric toxicity. The incidence of moderate to severe induced reactions is estimated at 5%. Acute cognitive induced disorders are common although moderate. These cognitive alterations specifically affect hippocampal dependant memory process. Chronic cognitive disorders are uncommon, complex, and inconsistent with an isolated alteration of the hippocampal structure. Corticotherapy stop also induced frequent psychiatric withdrawal symptoms, which are mostly depressive symptoms. Occurrence of such symptoms is likely to explain the addictive potentialities of glucocorticoids.
糖皮质激素诱发的精神障碍大多在皮质激素治疗的最初几周内出现。它们以多种性质不同的形式出现。躁狂症状是皮质类固醇诱发的精神毒性的最重要表现之一。中度至重度诱发反应的发生率估计为5%。急性认知诱发障碍很常见,尽管程度较轻。这些认知改变特别影响海马依赖性记忆过程。慢性认知障碍不常见、复杂,且与海马结构的单一改变不一致。停用皮质激素治疗也常诱发精神戒断症状,主要是抑郁症状。这些症状的出现可能解释了糖皮质激素的成瘾潜力。