CORTISONE-INDUCED DELUSIONAL DEPRESSION I N SYSTEMIC LUPUS-ERYTHEMATOSUS

A case of systemic lupus erythematodes (SLE) with development of a del usional depression is presented. Psychiatric symptoms in patients with SLE and in patients treated with glucocorticoids are discussed. The m ain psychiatric side effects of a therapy with steroids are a dose-dep endent, reversible dementia like syndrome and a probably not dose-depe ndent provocation of psychosis. Furthermore the role of the dysregulat ion of the limbic-hypothalamic-pituitary-adrenocortical axis in major depression is stressed and consequences for psychopharmacological trea tment are emphasized.