Neuropsychiatric Adverse Effects of Synthetic Glucocorticoids: A Systematic Review and Meta-Analysis
Authors' conclusion
The heterogeneity of glucocorticoid use is reflected in the available studies. Despite this heterogeneity, the proportion of neuropsychiatric adverse effects in glucocorticoid users is high. The most substantial associations with glucocorticoid use were found for depression and mania. Upon starting glucocorticoid treatment, awareness of possible psychiatric side effects is essential. More structured studies on incidence and potential pathways of neuropsychiatric side effects of prescribed glucocorticoids are clearly needed.
Study context
- Population
- Patients using synthetic glucocorticoids; studies assessing psychiatric side effects with validated questionnaires; 6 electronic databases searched49 studies
- Comparison
- Glucocorticoid users vs nonusers
- Outcome
- Proportion of neuropsychiatric adverse effects in synthetic glucocorticoid users
Methodological detailsrandom-effects logistic regression model, RCTs, cohort and cross-sectional studies, Risk of bias assessed with RoB 2, ROBINS-I and AXIS
- Random-effects logistic regression model
- RCTs, cohort and cross-sectional studies
- Risk of bias assessed with RoB 2, ROBINS-I and AXIS
Pooled result
As reported in the abstract
Pooled proportion of neuropsychiatric adverse effects in glucocorticoid users
- Depression, proportion
- 22% (95% CI 14%-33%)
- Mania, proportion (2%-46%)
- 11%
- Anxiety, proportion (2%-25%)
- 8%
- Delirium, proportion (6%-36%)
- 16%
- Behavioral changes, proportion (42%-61%)
- 52%
Further pooled results
| Outcome | SMD | |
|---|---|---|
| Depression questionnaire scores | 0.80 (95% CI 0.35–1.26) | |
| Mania questionnaire scores | 0.78 (CI 0.14–1.42) | |
| −1012Difference (linear scale) |
Original publication
Neuropsychiatric Adverse Effects of Synthetic Glucocorticoids: A Systematic Review and Meta-Analysis. J Clin Endocrinol Metab. Published 1 December 2023. doi:10.
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