2605.02673 STEROID-PSYCH: Glucocorticoid Psychiatric Toxicity Risk-Context Stratification Before or During Systemic Steroid Therapy in Autoimmune Disease
Systemic corticosteroids can precipitate insomnia, mood elevation, mania, depression, psychosis, or delirium. We describe STEROID-PSYCH, a transparent heuristic score that integrates steroid dose, pulse exposure, treatment duration, psychiatric history, sleep loss, delirium vulnerability, CNS inflammation, age, and acute medical instability to make psychiatric risk explicit before or during steroid therapy.