Psychiatric Symptoms Associated with Corticosteroid Use: A Systematic Review and Meta-analysis

作者：Keisuke Kusudo, Yuki Mashima, Hideaki Yasuda, Teruomi Iyo, Hiroyoshi Takeuchi · 发表于：CNS Drugs · 年份：2026 · DOI：10.1007/s40263-026-01298-5 · 被引用次数：1 · 研究领域：Stress Responses and Cortisol、Hormonal Regulation and Hypertension、Adrenal Hormones and Disorders

Corticosteroids (CSs) are widely prescribed but can induce psychiatric adverse effects (depressive, manic, psychotic, and anxiety symptoms). This systematic review aimed to quantify the association between CS use and psychiatric symptoms and to explore potential moderators across clinical contexts. We conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided systematic review and meta-analysis. MEDLINE and Embase were searched through 10 October, 2025, and 19 hand-searched records were also screened. We included observational studies in medical CS users and excluded sex steroids, neonatal exposure, prescription-only outcomes, purely objective outcomes, sleep/cognition/delirium-focused studies, CS deficiency, withdrawal, and studies confounded by co-medications; randomized controlled trials were excluded by design. Two reviewers screened studies, extracted data, and assessed risk of bias with the Newcastle-Ottawa Scale. Certainty of evidence for each pooled outcome was additionally evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Pairwise meta-analyses pooled standardized mean differences and odds ratios using random-effects models; I2 quantified heterogeneity. The acute phase was operationally defined as ≤ 8 weeks after CS initiation. An exploratory meta-regression across six studies (seven groups) examined dose, duration, cumulative dose, age, and sex. Seventy-three studies (total N =...