Ulcerative colitis in association with chronic paranoid schizophrenia: a review of steroid-induced psychiatric disorders.

A 21-year-old schizophrenic man developed ulcerative colitis. Because he might have needed steroids, we reviewed the literature on the use of steroids in patients with psychiatric disorders. The pathogenesis of psychiatric symptoms during steroid therapy is unknown. Development of psychiatric complications in patients receiving steroids is probably dose-dependent. The type of psychiatric manifestations is variable, ranging from affective through schizophreniform syndromes. It is unclear whether a history of psychiatric disorders increases the risk for psychiatric problems from steroids. In the majority of patients psychiatric complications remit when the dose of steroids is reduced or discontinued, or when appropriate pharmacotherapy and psychotherapy are administered. Preliminary studies suggest that lithium may prevent development of steroid psychosis.