Grover Sandeep, Sahoo Swapnajeet, Rijal Rika, Mehra Aseem
Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Brain Behav Immun Health. 2021 Dec;18:100345. doi: 10.1016/j.bbih.2021.100345. Epub 2021 Sep 15.
There is a sudden upsurge in the use of steroids due to the ongoing COVID-19 pandemic, especially in patients with severe or critical COVID-19 infection. There are reports of excessive use of steroids, both in terms of use in patients who do not require the same and use in doses higher than the recommended. There are reports of the emergence of different adverse outcomes of excessive steroid use in the form of diabetes mellitus and a higher incidence of mucormycosis. However, little attention has been paid to the mental health impact of the use of steroids. This review attempts to evaluate the existing data in terms of incidence of psychiatric side effects of steroids, and the risk factors for steroid associated psychiatric manifestations. Additionally, an attempt is made to discuss the pathogenesis of steroid-associated psychiatric side effects and why it is likely that the incidence of psychiatric side effects may be more in patients with COVID-19 infection. There is a need to improve the awareness about the psychiatric side effects of steroids, both among the physicians and mental health professionals, as in any patient presenting with new-onset psychiatric symptoms while having COVID-19 infection or during the post-COVID-19 infection phase, a possibility of steroid associated side effect needs to be considered.
由于持续的新冠疫情，类固醇的使用突然激增，尤其是在患有严重或危重型新冠感染的患者中。有报道称存在类固醇的过度使用情况，既包括在不需要使用类固醇的患者中使用，也包括使用剂量高于推荐剂量的情况。有报告称，过度使用类固醇出现了不同的不良后果，如糖尿病和毛霉菌病发病率升高。然而，类固醇使用对心理健康的影响却很少受到关注。本综述试图评估现有数据中类固醇精神科副作用的发生率以及类固醇相关精神症状的危险因素。此外，还尝试讨论类固醇相关精神科副作用的发病机制，以及为何新冠感染患者中精神科副作用的发生率可能更高。有必要提高医生和心理健康专业人员对类固醇精神科副作用的认识，因为在任何出现新发精神症状的新冠感染患者或新冠感染后阶段的患者中，都需要考虑类固醇相关副作用的可能性。
