Osteoporosis and fracture risk in people with schizophrenia

Taishiro Kishimoto, Marc De Hert, Harold E. Carlson, Peter Manu, Christoph U. Correll

Research output: Contribution to journalArticle

63 Citations (Scopus)

Abstract

PURPOSE OF REVIEW: Excessive bone mineral density (BMD) loss has been associated with schizophrenia, but its mechanisms and clinical implications are less clear. The aim of this review was to summarize the risk of osteoporosis and bone fractures in schizophrenia patients. Moreover, we aimed to examine the impact of antipsychotic-induced hyperprolactinemia on bone metabolism. RECENT FINDINGS: Fifteen of 16 studies (93.8%) reported lower BMD or higher prevalence of osteoporosis in at least one region, or in at least one subgroup of schizophrenia patients compared with controls, but results were inconsistent across measured areas. Higher fracture risk was associated with schizophrenia in 2/2 studies (independently: n = 1), and 3/4 studies with antipsychotics. Reasons for this difference include insufficient exercise, poor nutrition, smoking, alcohol use, and low vitamin D levels. Altogether, 9/15 (60.0%) studies examining the relationship between antipsychotic-induced hyperprolactinemia and BMD loss found some effects of hyperprolactinemia. However, results were mixed, samples and effects were small, and only two studies were prospective. SUMMARY: Schizophrenia is associated with reduced BMD and fracture risk. Prevention, early detection, and intervention are required. The relative contributions of antipsychotic-related hyperprolactinemia and unhealthy lifestyle behaviors remain unclear, needing to be assessed in well designed, prospective studies, including bone turnover markers as intermediary endpoints.

Original languageEnglish
Pages (from-to)415-429
Number of pages15
JournalCurrent Opinion in Psychiatry
Volume25
Issue number5
DOIs
Publication statusPublished - 2012 Sep

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Hyperprolactinemia
Osteoporosis
Schizophrenia
Bone Density
Antipsychotic Agents
Bone Fractures
Prospective Studies
Bone Remodeling
Vitamin D
Life Style
Smoking
Alcohols
Exercise
Bone and Bones

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Osteoporosis and fracture risk in people with schizophrenia. / Kishimoto, Taishiro; De Hert, Marc; Carlson, Harold E.; Manu, Peter; Correll, Christoph U.

In: Current Opinion in Psychiatry, Vol. 25, No. 5, 09.2012, p. 415-429.

Research output: Contribution to journalArticle

Kishimoto, Taishiro ; De Hert, Marc ; Carlson, Harold E. ; Manu, Peter ; Correll, Christoph U. / Osteoporosis and fracture risk in people with schizophrenia. In: Current Opinion in Psychiatry. 2012 ; Vol. 25, No. 5. pp. 415-429.
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