Cited by 92Schizophrenia research and treatmentBone health and osteoporosis researchBone Metabolism and Diseases

A meta-analysis of prevalence estimates and moderators of low bone mass in people with schizophrenia

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Stubbs, B., De Hert, M., Sepehry, A. A., Correll, C. U., Mitchell, A. J., Soundy, A., Detraux, J., Vancampfort, D.·2014·Acta Psychiatrica Scandinavica

Abstract

OBJECTIVE: To assess the prevalence and moderators of low bone mass, osteopenia and osteoporosis in schizophrenia patients. METHOD: Major electronic databases were searched from inception till December 2013 for studies reporting the prevalence of low bone mass (osteopenia + osteoporosis = primary outcome), osteopenia or osteoporosis in schizophrenia patients. Two independent authors completed methodological appraisal and extracted data. A random effects meta-analysis was utilized. RESULTS: Nineteen studies were included (n = 3038 with schizophrenia; 59.2% male; age 24.5-58.9 years). The overall prevalence of low bone mass was 51.7% (95% CI = 43.1-60.3%); 40.0% (CI = 34.7-45.4%) had osteopenia and 13.2% (CI = 7.8-21.6%) had osteoporosis. Compared with controls, schizophrenia patients had significantly increased risk of low bone mass (OR = 1.9, CI = 1.30-2.77, P < 0.001, n = 1872) and osteoporosis (OR = 2.86, CI = 1.27-6.42, P = 0.01, n = 1824), but not osteopenia (OR = 1.33, CI = 0.934-1.90, P = 0.1, n = 1862). In an exploratory regression analysis, older age (P = 0.004) moderated low bone mass, while older age (P < 0.0001) and male sex (P < 0.0001) moderated osteoporosis. The subgroup analyses demonstrated high heterogeneity, but low bone mass was less prevalent in North America (35.5%, CI = 26.6-45.2%) than Europe (53.6%, CI = 38.0-68.5%) and Asia (58.4%, CI = 48.4-67.7%), and in mixed in-/out-patients (32.9%, CI = 49.6-70.1%) vs. in-patients (60.3%, CI = 49.6-70.1%). CONCLUSION: Reduced bone mass (especially osteoporosis) is significantly more common in people with schizophrenia than controls.

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  1. STROUP DF, BERLIN JA, MORTON SC, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000;283:2008-12.
  2. AMERICAN PSYCHIATRIC ASSOCIATION. Diagnostic and Statistical Manual of Mental Disorders -DSM-IV-TR. 4th edition. American Psychiatric Association; 2000.
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Authors
Stubbs, B., De Hert, M., Sepehry, A. A., Correll, C. U., Mitchell, A. J., Soundy, A., Detraux, J., & Vancampfort, D.
Affiliations
  • University of Greenwich (GB)
  • University Psychiatric Centre; KU Leuven; Kortenberg; KU Leuven Department of Neurosciences; Kortenberg Belgium
  • University of British Columbia (CA)
  • Long Island Jewish Medical Center (US)
  • Leicester General Hospital (GB)
  • University of Birmingham (GB)
  • KU Leuven (BE)
Corresponding author
Stubbs, B.
Venue
Acta Psychiatrica Scandinavica
Publisher
Wiley
Published
2014-07-10
Volume
130
Issue
6
Pages
470-486
ISSN
0001-690X (ISSN-L)
OpenAlex
W2153079117
Cited by
92
References
61
Citations by year
2026: 3 · 2025: 2 · 2024: 5 · 2023: 7 · 2022: 7 · 2021: 9 · 2020: 6 · 2019: 11 · 2018: 8 · 2017: 6 · 2016: 15 · 2015: 10 · 2014: 3
FWCI
1.57
Type
journal article
Language
en
Open access
Locations
  • Acta Psychiatrica Scandinavica (publishedVersion)
  • PubMed (publishedVersion)
  • Greenwich Academic Literature Archive (University of Greenwich) (acceptedVersion)
  • Research Portal (King's College London) (submittedVersion)
  • Lirias (submittedVersion)
  • University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
Funders
  • Universiteit Maastricht
  • Maastricht Universitair Medisch Centrum
  • Hirosaki University
  • China Medical University
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
Keywords
moderators, osteopenia, osteoporosis, schizophrenia, bone mineral density, prevalence, age as moderator, sex differences, regional variation, antipsychotic adverse effects, osteoporosis risk factors, alcohol consumption, physical activity, body mass index
MeSH terms
Adult, Age Factors, Bone Diseases, Metabolic, Europe, Female, Humans, Male, Middle Aged, North America, Osteoporosis, Regression Analysis, Risk Factors, Schizophrenia, Antipsychotic Agents, Prevalence, Young Adult

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