“I was never like that”: Australian findings on the psychological and psychiatric sequelae of corticosteroids in haematology treatments
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Goals of work
Corticosteroid treatments have been well documented to cause severe emotional and even psychiatric disturbances. Despite that corticosteroid use is at the core of most treatment protocols for haematological malignancies, there is a dearth of published research (and controversy in the existing research) on the emotional and psychiatric sequelae of corticosteroid use for haematology patients and its connection with pre-existing mental history. This paper aims to address this hiatus and confusion by examining the emotional and psychiatric side effects of corticosteroids on haematology patients in Australia.
Materials and methods
The findings are from a pilot study that explored the prior mental health history and effects of corticosteroid use of ten haematology patients in Australia. Data was collected through an iterative, phenomenological, qualitative research methodology using open-ended interviews conducted at the time and location of the participant’s choice. The interviews were audio-recorded and transcribed verbatim. The language texts were then entered into the QSR NUD*IST computer program and analysed thematically.
The significant finding from the study was that corticosteroids used in haematology treatments have the potential to affect anyone and are not related to an individual’s prior mental health history. No participant presented evidence of psychiatric history or counseling and many reported emotional stability during previous times of difficulty. All participants reported emotional distress directly related to corticosteroid use. Participants reported difficulties during the period of withdrawal from corticosteroids and relief during periods free from the administration of corticosteroids.
The findings provide evidence that emotional disturbances associated with corticosteroid use in haematology are a direct result of the drugs used and not a symptom of the individual’s prior emotional health. Recommendations are given which have important implications for the management, support and education of patients and their families in relation to the potential emotional side effects from steroid administration and withdrawal.
KeywordsCorticosteroids Haematology Side effects Mental health Psychological
The authors would like to thank Mrs. Elaine Phillips for her excellent transcribing work and Dr. Michael Leahy, Dr. Paul Pun and Dr. Peter Mollee for providing access to the participants.
- 4.Crombie I (1996) Research in health care. Wiley, New YorkGoogle Scholar
- 6.Estrada D (2005) Consulting Staff, Hematology–Oncology, Cancer Care Specialists of Central Illinois. Lymphoma, Non-Hodgkin. http://www.emedicine.com/med/topic1363.htm. Accessed14 July 2006.
- 9.Guyton A, Hall J (2000) Textbook of medical physiology, 10th edn. Saunders, PhiladelphiaGoogle Scholar
- 10.Hardman JG, Limbird LE (2001) Goodman and Gilman’s the pharmacological basis of therapeutics, 10th edn. McGraw-Hill, New YorkGoogle Scholar
- 15.Kostic VS, Levic Z (1989) Psychiatric disorders associated with corticocorticosteroid therapy. Neurologia 38(2):161–166Google Scholar
- 16.Krathwohl D (1993) Methods of educational and social science research: an integrated approach. Longman, New YorkGoogle Scholar
- 20.McGrath P (2003) ‘Living well with grief’: insights on bereavement support. Austral–Asian J Cancer 2(3):225–233Google Scholar
- 22.McGrath P, Pun P, James S, Holewa H (2007) Psychological and psychiatric sequelae of corticosteroid use in Hematology treatments: a review of the literature. Austral–Asian J Cancer 6(2):87–95Google Scholar
- 26.Nakamae H, Yamane T, Aoyama Y, Yamamura R, Shima E, Makita K, Ohta K, Tatsumi N, Hino M (2002) Chronic myelogenous leukemia treated with non-myeloablative stem cell transplantation after discontinuing myeloablative stem cell transplantation due to mental aberrations. Jpn J Clin Hematol 43(7):573–577Google Scholar
- 28.Polit D, Hungler B (1995) Nursing research: principles and methods, 5th edn. Lippincott, PhiladelphiaGoogle Scholar
- 29.Rakel RE, Bope E (Eds) (2001) Conn’s current therapy. WB Sunders Company, LondonGoogle Scholar
- 30.Reinhart WH (2005) Corticosteroid therapy. Schweiz Rundsch Med Prax 94(7):239–243Google Scholar
- 35.Spiegelberg H (1975) Doing phenomenology. Nijhoff, The HagueGoogle Scholar
- 36.Streubert J, Carpenter D (1995) Qualitative research in nursing: advancing the humanistic imperative. Lippincott Company, New YorkGoogle Scholar
- 38.Van Manen M (1990) Researching lived experience. State University of New York Press, London, OntarioGoogle Scholar
- 40.Williams G, Dluhy R (2006) Disorders of the adrenal cortex; biochemistry and physiology. Harrison’s online: harrison’s principles of internal medicine, 16th edn. The McGraw-Hill Companies http://www.accessmedicine.com.ezproxy.library.uq.edu.au/content.aspx?aID=98445&searchStr=corticosteroids#98445. Accessed 20 July 2006