{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:16:33Z","timestamp":1785420993485,"version":"3.56.0"},"reference-count":23,"publisher":"Royal College of Psychiatrists","issue":"4","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"unspecified","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec id=\"S2056472426120274_as1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Glucocorticoids are widely prescribed for autoimmune and inflammatory conditions, but their long-term use carries serious risks. Patients with psychiatric disorders have a high burden of medical comorbidities, which may be associated with higher odds of receiving sustained glucocorticoid therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472426120274_as2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>We examined whether psychiatric patients were more likely to receive sustained oral glucocorticoid therapy compared with controls, and assessed variation across psychiatric subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472426120274_as3\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      This retrospective, nationwide cohort study used South Korea\u2019s National Health Insurance Service database. Adults diagnosed with a major psychiatric disorder in 2021 (\n                      <jats:italic>n<\/jats:italic>\n                      = 331 020) were compared with a sample without psychiatric disorders (\n                      <jats:italic>n<\/jats:italic>\n                      = 668 980). Propensity score matching generated 283 942 participants per group. The outcome was sustained oral glucocorticoid use in 2022, defined as \u226590 cumulative days with continuous therapy \u226590 days and prescription gaps \u226430 days.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472426120274_as4\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Before propensity score matching, glucocorticoid use in 2022 was more frequent in psychiatric patients (13.8%) than controls (10.8%; odds ratio 1.32, 95% CI 1.31\u20131.34;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001). After matching, the difference persisted (14.7\n                      <jats:italic>v<\/jats:italic>\n                      . 12.5%; odds ratio 1.18, 95% CI 1.16\u20131.19;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001). Multivariable analyses confirmed higher odds of glucocorticoid use (odds ratio 1.05, 95% CI 1.03\u20131.06;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001). Increased risk was observed for anxiety disorders (odds ratio 1.06) and obsessive\u2013compulsive disorder (odds ratio 1.07), whereas major depressive disorder showed no significant association.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472426120274_as5\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Psychiatric patients are more likely to receive sustained glucocorticoid therapy, underscoring the need for cautious prescribing and monitoring in this vulnerable population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjo.2026.12027","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T03:52:41Z","timestamp":1783050761000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Disparities in oral glucocorticoid prescribing among patients with mental disorders: nationwide cohort study"],"prefix":"10.1192","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4027-4423","authenticated-orcid":false,"given":"Tak Kyu","family":"Oh","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00cb3km46","id-type":"ROR","asserted-by":"publisher"}],"name":"Seoul National University Bundang Hospital"},{"name":"Seoul National University College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7814-4253","authenticated-orcid":false,"given":"In-Ae","family":"Song","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00cb3km46","id-type":"ROR","asserted-by":"publisher"}],"name":"Seoul National University Bundang Hospital"},{"name":"Seoul National University College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"S2056472426120274_ref5","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2013.3074"},{"key":"S2056472426120274_ref6","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2014.2502"},{"key":"S2056472426120274_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/S0163-7258(02)00297-8"},{"key":"S2056472426120274_ref7","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20420"},{"key":"S2056472426120274_ref3","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e4928"},{"key":"S2056472426120274_ref22","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.2008.01211.x"},{"key":"S2056472426120274_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"S2056472426120274_ref16","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1984.10478078"},{"key":"S2056472426120274_ref8","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2015.2688"},{"key":"S2056472426120274_ref17","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgad701"},{"key":"S2056472426120274_ref19","doi-asserted-by":"publisher","DOI":"10.1177\/20503121241235056"},{"key":"S2056472426120274_ref20","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j1415"},{"key":"S2056472426120274_ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2019.09.002"},{"key":"S2056472426120274_ref1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-015905"},{"key":"S2056472426120274_ref2","doi-asserted-by":"publisher","DOI":"10.1002\/art.21984"},{"key":"S2056472426120274_ref10","article-title":"Oral glucocorticoids and risk of psychiatric and suicidal behaviour outcomes: population-based cohort study","author":"Lagerberg","journal-title":"Br J Psychiatry"},{"key":"S2056472426120274_ref14","first-page":"e15","article-title":"Cohort profile: the national health insurance service\u2013national sample cohort (NHIS-NSC), South Korea","volume":"46","author":"Lee","year":"2017","journal-title":"Int J Epidemiol"},{"key":"S2056472426120274_ref12","doi-asserted-by":"publisher","DOI":"10.4065\/81.10.1361"},{"key":"S2056472426120274_ref15","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-024-07023-6"},{"key":"S2056472426120274_ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.103026"},{"key":"S2056472426120274_ref18","doi-asserted-by":"publisher","DOI":"10.3390\/diseases12120300"},{"key":"S2056472426120274_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.psym.2011.12.007"},{"key":"S2056472426120274_ref9","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2011.11071009"}],"container-title":["BJPsych 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Published by Cambridge University Press on behalf of Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e173"}}