A CASE-CONTROL STUDY OF CORTICOSTEROID EXPOSURE AS A RISK FACTOR FOR CLINICALLY-DIAGNOSED DEPRESSIVE-DISORDERS IN A HOSPITALIZED POPULATION

Objective: Depressive symptoms may be a side effect of exogenous corti costeroids. However, the literature does not confirm that corticostero id exposure is associated with the occurrence of depressive disorders. The objective of this study was to determine whether or not corticost eroid exposures are associated with clinical diagnoses of depressive d isorders in hospitalized patients. Method: The study used a case-contr ol design. Cases and 2 control groups were selected from a health reco rds case summary database maintained at the Calgary General Hospital. Additional data were collected by chart review. Results: The analysis reproduced associations between depressive diagnoses and several psych osocial and biological risk factors. However the data did not suggest that corticosteroids were associated with an elevated risk of depressi ve diagnoses. In fact, odds ratios for corticosteroid exposure were le ss than 1, consistent with a protective effect Conclusions: Although c orticosteroids may produce depressive symptoms as a side effect, corti costeroid exposures are not associated with an elevated risk of clinic ally diagnosed depressive disorders in hospitalized patients. There ar e several possible explanations for this Depressive syndromes associat ed with corticosteroid exposure may not clinically resemble depressive disorders, and may not warrant a diagnosis of a depressive disorder. Alternatively, clinicians may not identify, and formally diagnose depr essive disorders caused by corticosteroids.