Corticosteroid-induced mood changes in systemic autoimmune diseases: a multicentric study

Introduction
Major depressive disorder (MD) is a significant mental health issue projected to become the leading contributor to the global burden of disease by 2030. MD substantially increases between teenage years and early adulthood. In addition, 25% of mood disorders manifest by 18 years old and 50% by age 30. Prior research investigated the relationship between the administration of corticosteroids and the onset of depression, revealing notable depressive symptoms and occurrences of depression in individuals undergoing corticosteroid treatment.

Aim
We aimed to determine the prevalence of depression following corticosteroid therapy among a cohort of patients who received corticosteroids.

Material and methods
This cross-sectional study was carried out at various centers, including Al-Azhar University Hospitals, involving a cohort of 500 cases.

Results
The results of the Beck Depression Inventory showed a significant increase across all questionnaire items following corticosteroid therapy. The mean total score was 6.02 ±2.05 before corticosteroid therapy and 11.28 ±7.94 after therapy, showing a significant increase (p < 0.001). None of the participants exhibited depression before corticosteroid therapy, according to the Beck Depression Inventory. Following corticosteroid therapy, 26% of cases experienced depression, with 10% being mild, 6% moderate, 8% severe, and 2% very severe. Significant changes were observed in body mass index, C-reactive protein, glycated hemoglobin, serum total calcium, and systolic blood pressure (p < 0.001).

Conclusions
The presence of depression and severity of depression were significantly higher after corticosteroid therapy compared to before therapy.