IMPACT OF ACUTE STEROID TREATMENT ON MEMORY, EXECUTIVE FUNCTION, AND MOOD IN PEDIATRIC INFLAMMATORY BOWEL DISEASE

Abstract

Introduction: Corticosteroids, which are critical for therapy of pediatric inflammatory bowel disease (IBD), can adversely affect the nervous system, changing sleep, appetite, and mood. Less is known, however, about their impact on cognition and memory, especially in children. We investigated the effects of high-dose steroids on memory, cognition and mood in children with IBD. Methods: Children (age 8-17) with IBD on high-dose steroids (≥30 mg/day prednisone) (N = 14: 7 CD, 7 UC) were compared to those off steroids for ≥6 months (N = 15; 13 CD, 2 UC). Assessment included the Wide Range Assessment of Memory and Learning (WRAML Stories), Children's Memory Scale (CMS Faces), Rey Osterrieth Complex Figure (ROCF), Trails, Behavior Rating Inventory of Executive Functions (BRIEF)-self and parent report, Child Behavior Checklist (CBCL)/Youth Self-Report (YSR), and measures of IQ, pain and sleep. Results: The high-dose steroid group (M = 40 mg, range 30-75 mg) had poorer short-term memory for details, slower speed, and reported more problems with working memory, shifting, mood, and sleep (p = .075) (Table). Demographics, IQ, and pain level were comparable between groups. Sleep problems accounted partly for group differences.TableConclusions: Steroids affect short-term memory, speed, executive function and mood in children treated acutely for IBD. The impact of steroid-related sleep problems on memory and mood should be considered when helping patients manage drug side effects. Longitudinal studies are warranted to examine the reversibility of these effects.