ArticleThe British journal of psychiatry : the journal of mental science2026
Oral glucocorticoids and risk of psychiatric and suicidal behaviour outcomes: population-based cohort study.
Article in The British journal of psychiatry : the journal of mental science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Psychiatric Symptoms Associated with Corticosteroid Use: A Systematic Review and Meta-analysis.CNS drugs · 2026Pooled it
- Article
- Systemic Corticosteroids in the Management of Sinonasal Disease: An Evidence-Based Expert Review.International forum of allergy & rhinology · 2026Review
- Duration-Dependent Adverse Events of Systemic Glucocorticosteroids in Atopic Dermatitis: A Nationwide Claims Cohort Study.Dermatology and therapy · 2026Article
- Glucocorticoid reduction after starting crinecerfont in pediatric patients with classic congenital adrenal hyperplasia: practical perspectives.The Journal of clinical endocrinology and metabolism · 2026Review
- Disparities in oral glucocorticoid prescribing among patients with mental disorders: nationwide cohort study.BJPsych open · 2026Article
- The Skin-Brain Axis in Psoriasis and Depression: Roles of Inflammation, Hormones, Neuroendocrine Pathways, Neuropeptides, and the Microbiome.Psoriasis (Auckland, N.Z.) · 2025Review
- Safe Use of Corticosteroids in Non-Infectious Uveitis.Journal of inflammation research · 2025Review
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundDespite evidence of associations between glucocorticoid treatment and adverse psychiatric and suicidal behaviour outcomes, large-scale observational evidence for serious outcomes is lacking.
aimsTo assess the risk of psychiatric and suicidal behaviour outcomes during glucocorticoid treatment.
methodUsing Swedish population registers, we identified 1 105 964 individuals aged 15-54 years who collected a glucocorticoid prescription in oral form between 2006 and 2020. We investigated associations with a range of psychiatric outcomes: unplanned specialist healthcare contacts due to depressive, bipolar, anxiety or schizophrenia-spectrum disorders; and deaths by suicide or unplanned specialist healthcare contacts due to self-harm ('suicidal behaviour'). We estimated hazard ratios from Cox proportional hazards models in a medication-only cohort by comparing outcome rates during and outside treated periods within individuals. We further identified individuals with an autoimmune or gastrointestinal autoimmune disorder diagnosis and compared hazards of the outcomes between those who did and did not initiate a glucocorticoid using a target trial emulation approach.
resultsWe found increased risks for psychiatric outcomes, with within-individual hazard ratios ranging from 1.08 (95% CI, 1.00-1.16) for depressive disorders to 1.23 (95% CI, 1.12-1.36) for bipolar disorder and 1.25 (95% CI, 1.20-1.31) for anxiety disorders. We found no clear association with suicidal behaviour (hazard ratio: 1.06; 95% CI, 0.96-1.17). These findings were similar when stratified by age and gender. Within-individual associations were attenuated in those diagnosed with an autoimmune disorder. The risk of anxiety and bipolar disorder outcomes appeared particularly elevated in the first weeks of treatment. Absolute rates were modestly elevated during treatment, and higher in those with a history of psychiatric disorders.
conclusionsGlucocorticoid treatment is associated with elevated risks of serious psychiatric outcomes, including the onset and relapse of common psychiatric disorders. Individuals with psychiatric histories may require additional monitoring during glucocorticoid treatment.
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What Socratic holds
Registered trials
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