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 distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.006 |
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; both teacher heads agree on what is shown here.
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".