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The Capital Region of Denmark - a part of Copenhagen University Hospital
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Glucocorticoids and the risk of schizophrenia spectrum disorder in childhood and adolescence - A Danish nationwide study

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  1. Emotion recognition latency, but not accuracy, relates to real life functioning in individuals at ultra-high risk for psychosis

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  2. During day and night: Childhood psychotic experiences and objective and subjective sleep problems

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  3. Anomalies of imagination in the schizophrenia-spectrum: Empirical findings

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  4. Evidence that self-reported psychotic experiences in children are clinically relevant

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  1. A large-scale genomic investigation of susceptibility to infection and its association with mental disorders in the Danish population

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  2. Visual attention in adults with attention-deficit/hyperactivity disorder before and after stimulant treatment

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  3. Validation of the Danish version of the brief negative symptom scale

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Glucocorticoids can have psychosis as a potential side effect, but have also been suggested to yield protective effects due to anti-inflammatory properties. Nonetheless, knowledge is sparse on the association between glucocorticoid treatment and development of psychosis, which we aimed to study in this first large-scale longitudinal study. Among all individuals born in Denmark 1995-2003 (n=597,257), we compared individuals who had redeemed ≥1 prescription for glucocorticoids to an active comparator group and a non-exposed group concerning subsequent development of schizophrenia spectrum disorders until 2013. Hazard rate ratios (HRR) were estimated using Cox regression adjusted for calendar year, age, gender, urbanization, somatic diseases, parental educational level and psychiatric history. The risk for a subsequent diagnosis of early-onset schizophrenia spectrum disorder (N=1141) was increased after exposure to both non-systemic (HRR=1.47; 95%-CI=1.25-1.73; N=371) and systemic glucocorticoids (HRR=1.66; 95%-CI=1.13-2.43; N=34), when compared to non-exposed individuals. Similar elevated risks were observed when comparing to the active comparator group, for schizophrenia and acute psychosis, and within an older cohort. The risk of psychosis was elevated the most within the first year after exposure to glucocorticoids (P<0.001) without any indication for a dose-response association. However, in individuals with asthma, exposure to glucocorticoids did not further increase the risk of psychosis. Glucocorticoid exposure was associated with an increased risk for psychotic disorders, which may be explained by an effect of the underlying somatic disease, such as asthma. A potential beneficial effect of glucocorticoids on psychotic symptoms should be investigated in clinical trials.

Original languageEnglish
Article number199
JournalSchizophrenia Research
Pages (from-to)116-122
Number of pages7
ISSN0920-9964
DOIs
Publication statusPublished - 19 Sep 2018

ID: 54977248