Objectives: This study proposes to clarify the development of corticosteroid-induced psychosis
focusing on risk factors, the onset timing of symptoms and therapeutic strategy.
Background and aims: Corticosteroids are a potent therapeutic option in medicine in general,
especially in high-dose treatments (higher than 40 mg/day of prednisone or equivalent), which
is associated with a 20% risk of developing severe psychiatric symptomatology that justifies
the use of psychotropics similar to those used in the same idiopathic psychopathologies.
Materials and methods: Systematic review on neuropsychiatric effects of corticosteroid
treatment using as a database: Medline and PubMed, illustrated by a case report with
information from a clinical interview.
Results: We report the case of a 51-year-old female patient, recently diagnosed with breast
cancer, who underwent mastectomy and axillary lymph node clearance and was under
adjuvant chemotherapy (submitted to a high dose of corticosteroids as integral part of the
scheme. The patient checked into the emergency room with behavioral alterations, delusions
of mystical and paranoid content, and auditory hallucinations. Given the absence of psychiatric
antecedents, and after exclusion of organic cause, delusional alterations were interpreted as a
direct result of corticotherapy, a known cause of the symptomatology described abo. Clinical
improvement was observed with the establishment of antipsychotic therapy.
Conclusion: Due to the significant risk of corticosteroid-induced psychosis and the absence of
applicable guidelines, it is important to address this issue, alerting health professionals to the
possible therapeutic strategies, with antipsychotics and mood stabilizers, outcome and
expected evolution of the symptoms.

WHEN THE DISEASE ARISES FROM THE TREATMENT: CORTICOSTEROID-INDUCED PSYCHOSIS A CASE REPORT AND BRIEF LITERATURE REVIEW