The Emotional Consequences of Corticosteroid Use in Hematology: Preliminary Findings

Abstract

This article presents the findings from a pilot study conducted as a first step in understanding the myriad psychological and psychiatric sequelae stemming from the use of steroids for hematology patients. Descriptions of the side effects experienced by 10 hematology patients undergoing steroid treatment are documented and discussed. Steroid usage can have a range of physical and emotional side effects on patients, including hematology patients. The insights are a serious reminder to all who care for hematology patients that the psychological and psychiatric side effects of steroids need to be taken seriously.

Psychiatric sequelae of corticosteroid use in hematology in Australia: A qualitative study

“…Family members can feel threatened and fearful of the anger and aggression exhibited by patients experiencing severe adverse effects. Challenges experienced by family members living with patients receiving cancer-related steroid treatment were also reported byMcGrath and Holewa (2010). We concur with McGrath…”

“…Symptoms usually resolve after drug cessation. While few studies examining the psychiatric effects of corticosteroids in cancer populations exist, McGrath, Pun, James, and Holewa (2007) have conducted the most extensive qualitative research, investigating effects in both pediatric (McGrath, 2002;McGrath & Pitcher, 2002;McGrath & Rawson-Huff, 2010) and adult outpatient populations (McGrath & Holewa, 2010;McGrath, Patton, & Leahy, 2009b). Pediatric patients with cancer experienced considerable distress while on steroids, with associated emotional and behavioral changes impacting heavily on family members (McGrath, 2002;McGrath & Pitcher, 2002;McGrath & Rawson-Huff, 2010).…”

“…Psychiatric disturbances associated with corticosteroid use were found to be directly related to drugs used, rather than premorbid characteristics (McGrath, Patton, & James, 2009a). Participants were reported as having received inadequate information on reasons for steroid use and their effects (McGrath & Holewa, 2010).…”

“…Coping strategies utilized included recognizing that adverse effects reflected “the drug and not the person”, behavioral strategies, antidepressants, and social supports (McGrath et al, ). Findings also revealed that: myeloma patients could gain pleasure from increased mobility arising from corticosteroid usage (McGrath & Holewa, ). Psychiatric disturbances associated with corticosteroid use were found to be directly related to drugs used, rather than premorbid characteristics (McGrath, Patton, & James, ).…”

Non-infectious chemotherapy-associated acute toxicities during childhood acute lymphoblastic leukemia therapy

“…Corticosteroids frequently cause transient changes in sleep pattern, mood, and cognition, and this can be quite burdensome to both patients and parents 46 . Corticosteroids may affect the neurotransmitters dopamine or serotonin, deregulate the hypothalamic-pituitary-adrenal (HPA) axis, and cause hippocampal injury 47 .…”