Obsessive compulsive disorder due to dexamethasone use
Bibliographic record
Abstract
Obsessive-compulsive disorder (OCD) has a prevalence of approximately 2% and in rare instances, can be induced by medications. Previously, lamotrigine, clozapine and olanzapine have been associated with inducing obsessive-compulsive symptoms. Corticosteroids can also cause various psychiatric side effects, although obsessive-compulsive symptoms are rarely observed as an adverse effect. To date, there has been scant literature available on dexamethasone-induced obsessive-compulsive disorder. The recommended treatment in cases of dexamethasone-induced obsessive compulsive and related disorders is corticosteroid discontinuation. In previous case reports, Selective Serotonin Re-uptake Inhibitors (SSRI) medications have been used as an adjunct therapy, especially if the patient requires continuous corticosteroid therapy to maintain medical stability. Due to the rarity of dexamethasone-induced OCD and the inherent limitations of a case report, there would be benefit from future research to further investigate these findings. In our patient, he had previously taken two subsequent 6-day courses of dexamethasone 4 mg daily, in the context of dental surgery complications with no prior symptoms of OCD experienced. Three days after the last dose of dexamethasone, he started a third course of dexamethasone 4 mg daily and developed obsessive thoughts about dying on the same day. He recovered spontaneously after 5 days of steroid discontinuation with no return of psychiatric symptoms at outpatient follow up 11 days later. This is the first case report of spontaneously resolved dexamethasone-induced OCD from low dose steroids in an adult patient without any prior psychiatric history or structural brain pathology.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".