Corticosteroid-Induced Psychosis: A Report of Two Cases and Review of the Literature

Abstract

Glucocorticoids, prescribed for their anti-inflammatory and immunosuppressive effects, are linked to psychiatric side effects, including corticosteroid-induced psychosis. This condition may manifest as affective, organic, or cognitive disturbances, and although the exact pathophysiology is not fully understood, it is believed that corticosteroids impact the hippocampus and hypothalamic-pituitary-adrenal axis, causing neuropsychiatric changes. This report presents two cases of psychosis following corticosteroid use: a 59-year-old man with rheumatoid arthritis and a 62-year-old woman with asthmatic bronchitis. Both cases demonstrated rapid symptom improvement with antipsychotic treatment, emphasizing the need for early intervention. Despite the unclear pathophysiology, corticosteroid-induced psychosis generally has a positive prognosis when promptly managed with drug discontinuation and pharmacological treatment.