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Case Reports in Medicine
Volume 2011 (2011), Article ID 564521, 4 pages
http://dx.doi.org/10.1155/2011/564521
Case Report

Homicide and Associated Steroid Acute Psychosis: A Case Report

1Service de Médecine Légale, CHU d'Angers, 49933 Angers Cedex 09, France
2Département de Psychiatrie et de Psychologie médicale, CHU d'Angers, 49933 Angers Cedex 09, France
3IFR 132, Université d'Angers, 49035 Angers, France

Received 22 June 2011; Revised 26 August 2011; Accepted 26 September 2011

Academic Editor: Massimo Gallerani

Copyright © 2011 G. Airagnes et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We report the case of an old man treated with methylprednisolone for chronic lymphoid leukemia. After two months of treatment, he declared an acute steroid psychosis and beat his wife to death. Steroids were stopped and the psychotic symptoms subsided, but his condition declined very quickly. The clinical course was complicated by a major depressive disorder with suicidal ideas, due to the steroid stoppage, the leukemia progressed, and by a sudden onset of a fatal pulmonary embolism. This clinical case highlights the importance of early detection of steroid psychosis and proposes, should treatment not be stopped, a strategy of dose reduction combined with a mood stabilizer or antipsychotic treatment. In addition have been revised the risks of the adverse psychiatric effects of steroids.