Are Steroid and Puerperal Psychoses Manifestations of Bipolar Disorder? A Case Series

Kamatchi, Rajkumar; Kumar Jainer, Ashok; Somashekar, Bettahalasoor; Marzanski, Marek; Pathania, Rani; Cook, Jenna; York Moore, William
February 2013
International Medical Journal;Feb2013, Vol. 20 Issue 1, p7
Academic Journal
Background: Corticosteroids can induce psychiatric symptoms and there is some evidence indicating a close relationship between steroid induced psychosis, puerperal psychosis and bipolar affective disorder. Design: Description of three cases of women who suffered manic episodes following exposure to either exogenous or endogenous steroids and diagnosed with bipolar affective disorder. Results: Our findings suggest that steroids, either used in therapy and/or fluctuations during parturition, might act as triggering factors in the onset of affective episodes in some individuals who have been genetically pre-disposed to bipolar illness. Conclusions: We suggest both steroids and puerperium trigger the onset of an affective episode in patients prone to bipolar affective disorder possibly through influencing a gene/group of genes. This hypothesis needs further examination by molecular genetic studies.


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