Association between corticosteroids and psychologic change in hospitalized asthmatic children

Thirty-two children (mean age 14 years) with chronic, severe asthma were evaluated through the course of short-term prednisone "burst" treatment. At high steroid day (mean dose = 61.4 mg), the children reported more symptoms of anxiety and depression and demonstrated diminished verbal memory relative to low steroid day (mean dose = 6.97 mg). Order effects (evaluation at high steroid day first versus low steroid day first) were not significant for these steroid-sensitive variables. No dose-related changes emerged on measures of hyperactivity, attention, impulsivity, or fine motor control. Five subject variables were examined as potential risk factors. No association emerged between psychologic change scores and age, socioeconomic status, IQ, or asthma severity. Significant findings indicated that, as children increasingly demonstrated emotional difficulty or were from dysfunctional families, they were more likely to experience negative psychologic changes associated with high-dose steroids.