Niall Seymour, Muhammad Fahmi Ismail, Kieran Doherty, Ann Bowler, Richard Bambury, Shahid Iqbal, Eugene M Cassidy
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In this study, we aimed to investigate the demographics, steroid exposure, referring indications, symptom profiles, and subsequent treatments of steroid-induced mental disorders in oncology patients.</p><p><strong>Methods: </strong>We conducted a retrospective chart review of patients diagnosed with a steroid-induced mental disorder, as assessed by the psycho-oncology team in Cork University Hospital from 2626 referrals to the service between January 2010 to December 2019.</p><p><strong>Results: </strong>In total, 297 patients had a diagnosis of steroid-induced mental disorder (11% of referrals). 60.6% were female and mean age ± standard deviation (SD) was 57.5 ± 12.9 years. Breast cancer was the most frequent malignancy among females. Haematological cancer was the most frequent among males and the second most frequent among females. The most commonly prescribed steroid was dexamethasone, followed by prednisolone. The median (interquartile range [IQR]) cumulative weekly prednisolone equivalent dose was 186 mg (125-350 mg), with a median (IQR) duration of steroid exposure before symptom onset of 14 (6-47) days. The most frequently recorded symptoms following psychiatric assessment included insomnia, anxiety, and irritability. Psychotropics were commenced in n = 174 (74%) patients, with antipsychotics prescribed to 62.1%. A watchful wait approach was adopted for 25.5% of the patients. 90.2% (n = 185/205) of the patients experienced either complete or partial resolution of the symptoms at their first clinical review.</p><p><strong>Conclusions: </strong>Steroid-induced mental disorders can cause significant comorbidity in patients receiving cancer treatment. The most common symptoms recorded during assessment included insomnia, anxiety, and irritability.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 4","pages":"e70137"},"PeriodicalIF":3.3000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009012/pdf/","citationCount":"0","resultStr":"{\"title\":\"Steroid-Induced Mental Disorders in Oncology Patients: A 10-Year Retrospective Case Series Review.\",\"authors\":\"Niall Seymour, Muhammad Fahmi Ismail, Kieran Doherty, Ann Bowler, Richard Bambury, Shahid Iqbal, Eugene M Cassidy\",\"doi\":\"10.1002/pon.70137\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Patients with cancer are commonly prescribed corticosteroids for a variety of indications. Corticosteroids have long been known to affect mental state. Neuropsychiatric effects range from insomnia, cognitive impairment, and mood symptoms to psychosis and mania. In this study, we aimed to investigate the demographics, steroid exposure, referring indications, symptom profiles, and subsequent treatments of steroid-induced mental disorders in oncology patients.</p><p><strong>Methods: </strong>We conducted a retrospective chart review of patients diagnosed with a steroid-induced mental disorder, as assessed by the psycho-oncology team in Cork University Hospital from 2626 referrals to the service between January 2010 to December 2019.</p><p><strong>Results: </strong>In total, 297 patients had a diagnosis of steroid-induced mental disorder (11% of referrals). 60.6% were female and mean age ± standard deviation (SD) was 57.5 ± 12.9 years. Breast cancer was the most frequent malignancy among females. Haematological cancer was the most frequent among males and the second most frequent among females. The most commonly prescribed steroid was dexamethasone, followed by prednisolone. The median (interquartile range [IQR]) cumulative weekly prednisolone equivalent dose was 186 mg (125-350 mg), with a median (IQR) duration of steroid exposure before symptom onset of 14 (6-47) days. The most frequently recorded symptoms following psychiatric assessment included insomnia, anxiety, and irritability. Psychotropics were commenced in n = 174 (74%) patients, with antipsychotics prescribed to 62.1%. A watchful wait approach was adopted for 25.5% of the patients. 90.2% (n = 185/205) of the patients experienced either complete or partial resolution of the symptoms at their first clinical review.</p><p><strong>Conclusions: </strong>Steroid-induced mental disorders can cause significant comorbidity in patients receiving cancer treatment. The most common symptoms recorded during assessment included insomnia, anxiety, and irritability.</p>\",\"PeriodicalId\":20779,\"journal\":{\"name\":\"Psycho‐Oncology\",\"volume\":\"34 4\",\"pages\":\"e70137\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2025-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009012/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Psycho‐Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/pon.70137\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Psycho‐Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/pon.70137","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
Steroid-Induced Mental Disorders in Oncology Patients: A 10-Year Retrospective Case Series Review.
Objective: Patients with cancer are commonly prescribed corticosteroids for a variety of indications. Corticosteroids have long been known to affect mental state. Neuropsychiatric effects range from insomnia, cognitive impairment, and mood symptoms to psychosis and mania. In this study, we aimed to investigate the demographics, steroid exposure, referring indications, symptom profiles, and subsequent treatments of steroid-induced mental disorders in oncology patients.
Methods: We conducted a retrospective chart review of patients diagnosed with a steroid-induced mental disorder, as assessed by the psycho-oncology team in Cork University Hospital from 2626 referrals to the service between January 2010 to December 2019.
Results: In total, 297 patients had a diagnosis of steroid-induced mental disorder (11% of referrals). 60.6% were female and mean age ± standard deviation (SD) was 57.5 ± 12.9 years. Breast cancer was the most frequent malignancy among females. Haematological cancer was the most frequent among males and the second most frequent among females. The most commonly prescribed steroid was dexamethasone, followed by prednisolone. The median (interquartile range [IQR]) cumulative weekly prednisolone equivalent dose was 186 mg (125-350 mg), with a median (IQR) duration of steroid exposure before symptom onset of 14 (6-47) days. The most frequently recorded symptoms following psychiatric assessment included insomnia, anxiety, and irritability. Psychotropics were commenced in n = 174 (74%) patients, with antipsychotics prescribed to 62.1%. A watchful wait approach was adopted for 25.5% of the patients. 90.2% (n = 185/205) of the patients experienced either complete or partial resolution of the symptoms at their first clinical review.
Conclusions: Steroid-induced mental disorders can cause significant comorbidity in patients receiving cancer treatment. The most common symptoms recorded during assessment included insomnia, anxiety, and irritability.
期刊介绍：
Psycho-Oncology is concerned with the psychological, social, behavioral, and ethical aspects of cancer. This subspeciality addresses the two major psychological dimensions of cancer: the psychological responses of patients to cancer at all stages of the disease, and that of their families and caretakers; and the psychological, behavioral and social factors that may influence the disease process. Psycho-oncology is an area of multi-disciplinary interest and has boundaries with the major specialities in oncology: the clinical disciplines (surgery, medicine, pediatrics, radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology.
This international journal is published twelve times a year and will consider contributions to research of clinical and theoretical interest. Topics covered are wide-ranging and relate to the psychosocial aspects of cancer and AIDS-related tumors, including: epidemiology, quality of life, palliative and supportive care, psychiatry, psychology, sociology, social work, nursing and educational issues.
Special reviews are offered from time to time. There is a section reviewing recently published books. A society news section is available for the dissemination of information relating to meetings, conferences and other society-related topics. Summary proceedings of important national and international symposia falling within the aims of the journal are presented.
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