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Osteoporosis in Patients With Schizophrenia
Abstract
OBJECTIVE: Osteoporosis is regularly mentioned as a possible consequence of treatment with prolactin-increasing antipsychotic medications, but little is known about the prevalence and the degree of loss of bone mineral density in patients suffering from schizophrenia. The authors' goals were to investigate the association between schizophrenia and a decrease in bone mineral density and to get more insight into potential underlying pathophysiological mechanisms. METHOD: In a cross-sectional study, the authors used dual x-ray absorptiometry to determine bone mineral density of 75 inpatients and outpatients suffering from schizophrenia. All patients had been treated with antipsychotics for at least 1 year, and only patients between the ages of 19 and 50 were studied to exclude patients with age-related idiopathic osteoporosis. RESULTS: In men but not women with schizophrenia, bone mineral density was significantly lower than normal in the lumbar region. A comparison of loss of bone mineral density in male and female patients showed significant differences between the sexes. Bone mineral density showed a negative correlation with negative symptoms and Positive and Negative Syndrome Scale total score and a positive correlation with 25-hydroxy-vitamin D3 levels and body mass index in male patients. In female patients, a positive correlation between body mass index and bone mineral density was found. Exposure to prolactin-increasing antipsychotics was not related to bone mineral density. CONCLUSIONS: The male patients with schizophrenia in this study suffered from low bone density. This finding as well as other reports lend support to directing more attention to bone metabolism in patients with schizophrenia, although there is no universally accepted screening policy to identify individuals at high risk for osteoporosis.
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“Oral health status is a frequently disregarded health issue among SMI patients (498), with low rates of dental examination within the past 12 months (569,577-579).”
From Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care (2011) · cites this paper as [498]
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DE HERT, M., CORRELL, C. U., BOBES, J., CETKOVICH‐BAKMAS, M., COHEN, D., ASAI, I., DETRAUX, J., GAUTAM, S., MÖLLER, H., NDETEI, D. M., et al. (2011) · World Psychiatry · doi:10.1002/j.2051-5545.2011.tb00014.x · Cited by 2,488
“Some studies (490493) found a relationship between the use of prolactin-raising medication and low BMD in patients with chronic schizophrenia, while others (474,489,494-498) failed to find a relationship between prolactin, AP and osteoporosis.”
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Leucht, S., Burkard, T., Henderson, J., Maj, M., & Sartorius, N. (2007) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2007.01095.x · Cited by 633
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Antipsychotic‐Induced Hyperprolactinemia
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Secondary Effects of Antipsychotics: Women at Greater Risk Than Men
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“What the investigators found was that the body mass index (BMI) correlated positively with BMD: the more weight, the denser the bone in both sexes.(6) Howard et al.”
BackgroundTics and Tourette syndrome in autism spectrum disorders
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Risk of hip fracture in patients with a history of schizophrenia
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BackgroundInfluentialFracture Risk From Psychotropic Medications: A Population-Based Analysis
Bolton, J. M., Metge, C., Lix, L., Prior, H., Sareen, J., & Leslie, W. D. (2008) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e31817d5943 · Cited by 158
Valipour, G., Saneei, P., & Esmaillzadeh, A. (2014) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2014-1887 · Cited by 151
Advantages and disadvantages of combination treatment with antipsychotics
Goodwin, G. M., Fleischhacker, W., Arango, C., Baumann, P., Davidson, M., Binder, M. D., Falkai, P., Kapur, S., Leucht, S., Licht, R. W., et al. (2009) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2009.04.003 · Cited by 149
“There are high rates of osteoporosis and osteopenia in those taking long-term antipsychotic drugs (Hummer et al., 2005) and this may is related to the dose and duration of treatment, although confounded by other risk factors in this patient group.”
BackgroundSelf-citationA review of the association between antipsychotic use and hyperprolactinaemia
Bushe, C., Shaw, M., & Peveler, R. (2008) · Journal of Psychopharmacology · doi:10.1177/0269881107088435 · Cited by 148
Second-Generation Antipsychotics
Aichhorn, W., Whitworth, A. B., Weiss, E. M., & Marksteiner, J. (2006) · Drug Safety · doi:10.2165/00002018-200629070-00004 · Cited by 135
Low bone density in patients receiving methadone maintenance treatment
Kim, T. W., Alford, D. P., Malabanan, A., Holick, M. F., & Samet, J. H. (2006) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2006.05.027 · Cited by 131
Osteoporosis and fracture risk in people with schizophrenia
Kishimoto, T., Binder, M. D., Carlson, H. E., Manu, P., & Correll, C. U. (2012) · Current Opinion in Psychiatry · doi:10.1097/yco.0b013e328355e1ac · Cited by 121
“[43] also found a trend-level negative correlation between duration of treatment and z-score (r(2)1⁄40.”
BackgroundOral opioids for chronic non-cancer pain: higher prevalence of hypogonadism in men than in women
Fraser, L.-A., Morrison, D., Morley-Forster, P., Paul, T., Tokmakejian, S., Larry Nicholson, R., Bureau, Y., Friedman, T., & Uum, S. H. M. V. (2008) · Experimental and Clinical Endocrinology & Diabetes · doi:10.1055/s-2008-1076715 · Cited by 112
“A high prevalence of osteoporosis has also been found in men with depression (Mussolino et al., 2004) and schizophrenia (Hummer et al., 2005).”
BackgroundThe role of the phosphatidylinositide 3-kinase–protein kinase B pathway in schizophrenia
Kalkman, H. O. (2006) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2005.10.014 · Cited by 107
Schizophrenia and the risk of fractures: a systematic review and comparative meta-analysis
Stubbs, B., Gaughran, F., Mitchell, A. J., Binder, M. D., Farmer, R., Soundy, A., Rosenbaum, S., & Vancampfort, D. (2015) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2015.01.004 · Cited by 103
“The assessment tool focuses on three main methodological features: (1) the selection of the groups, (2) the comparability of the groups and (3) the ascertainment of the outcome of interest.”
MethodHyperprolactinemia in antipsychotic-naive patients with first-episode psychosis
Riecher‐Rössler, A., RYBAKOWSKI, J. K., Pflueger, M. O., Beyrau, R., Kahn, R. S., Malik, P., & Fleischhacker, W. W. (2013) · Psychological Medicine · doi:10.1017/s0033291713000226 · Cited by 104
“…has also been associated with osteopenia and osteoporosis (O‘Keane & Meaney, 2005) and an increase in the risk of bone fracture (Howard et al. 2007), although exposure to prolactin-increasing antipsychotics in one study was not found to be related to bone mineral density (Hummer et al. 2005).”
BackgroundSelf-citationA meta-analysis of prevalence estimates and moderators of low bone mass in people with schizophrenia
Stubbs, B., De Hert, M., Sepehry, A. A., Correll, C. U., Mitchell, A. J., Soundy, A., Detraux, J., & Vancampfort, D. (2014) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12313 · Cited by 92
“Eight studies (36, 37, 39–41, 48–50) (n = 1883) were conducted in in-patient settings, six included out-patients (33, 34, 42, 43, 45, 46) (n = 525), four studies included participants from mixed settings (35, 38, 44, 51) (n = 545), and the setting was unclear in one study (47) (n = 85).”
BackgroundInfluentialMalík, P., Gasser, R. W., Kemmler, G., Moncayo, R., FINKENSTEDT, G., Kurz, M., & Fleischhacker, W. W. (2008) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.2008.00847.x · Cited by 93
“This has been found in a number of previous studies in alcoholics (Bjorneboe et al., 1988; Hickish et al., 1989; Lindholm et al., 1991) aswell as in other psychiatric patients (Hummer et al., 2005).”
ResultSelf-citationBushe, C., & Shaw, M. (2007) · Journal of Psychopharmacology · doi:10.1177/0269881107078281 · Cited by 91
“In another crosssectional study of 75 inpatients and outpatients with schizophrenia hyperprolactinaemia was found in 44% females and 23% males (Hummer et al., 2005).”
BackgroundInfluentialAntipsychotic use and the risk of hip/femur fracture: a population-based case–control study
Pouwels, S., van Staa, T. P., Egberts, T. C. G., Leufkens, H. G. M., Cooper, C. C., & de Vries, F. (2009) · Osteoporosis International · doi:10.1007/s00198-008-0826-5 · Cited by 87
“Among current users we assessed the sedative, extrapyramidal, prolactin-raising, and orthostatic hypotensive pharmacological properties of the antipsychotic dispensed as determined by an extensive review of the literature [1, 4, 6, 26–32] (Table 1).”
MethodBinder, M. D., Detraux, J., & Stubbs, B. (2016) · Expert Opinion on Drug Safety · doi:10.1517/14740338.2016.1167873 · Cited by 82
“also stimulated or inhibited by most of these factors, as well as by other factors such as vitamin A.[18,45,46] Regardless of”
BackgroundBolton, J. M., Targownik, L. E., Leung, S., Sareen, J., & Leslie, W. D. (2010) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e3182075587 · Cited by 66
“Several studies have focused on antipsychotic medications, albeit with mixed findings.(17,18) Factors precluding a clear understanding include clinical samples limited in size and the fact that the indication for antipsychotic medication in most of these cohorts (schizophrenia) is itself associated with reduced bone d…”
BackgroundHow gender affects the pharmacotherapeutic approach to treating psychosis – a systematic review
Lange, B., Mueller, J. K., Leweke, F. M., & Bumb, J. M. (2017) · Expert Opinion on Pharmacotherapy · doi:10.1080/14656566.2017.1288722 · Cited by 60
“Osteoporosis/low bone mass Hummer et al. (2005) 75 patients Schizophrenia -Male patients had significantly lower bone mineral density than HC -Significant difference between sexes Halbreich et al. (1995) 68 patients Major depression, schizophrenia, schizoaffective disorder, mania, adjustment…”
BackgroundRisk of osteoporosis and fracture incidence in patients on antipsychotic medication
Graham, S. M., Howgate, D. J., Anderson, W. C., Howes, C., Heliotis, M., Mantalaris, A., Tsiridis, E. E., & Tsapakis, E.-M. (2011) · Expert Opinion on Drug Safety · doi:10.1517/14740338.2011.560112 · Cited by 57
“relatively short periods of treatment in both men and women [41,43-45,58,122].”
BackgroundInfluentialProlactin level during 5 years of risperidone treatment in patients with psychotic disorders
Eberhard, J., Lindström, E., Holstad, M., & Levander, S. E. (2007) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2006.00897.x · Cited by 57
“(18) an assumed relationship between osteoporosis and prolactin-increasing antipsychotics could not be corroborated, except and maybe for men and one anatomical structure (mineral loss in the lumbar region).”
van der Burgh, A. C., de Keyser, C. E., Zillikens, M. C., & Stricker, B. H. C. (2021) · Drugs · doi:10.1007/s40265-021-01625-8 · Cited by 60
Effects of Antipsychotics on Bone Mineral Density in Patients with Schizophrenia: Gender Differences
Chen, C., Lane, H., & Lin, C. (2016) · Clinical Psychopharmacology and Neuroscience · doi:10.9758/cpn.2016.14.3.238 · Cited by 60
Doknić, M., Marić, N. P., Britvić, D., Pekić, S., Damjanović, A., Miljić, D., Stojanović, M. D. M., Radojicic, Z. A., Gašić, M. J., & POPOVIC, V. M. (2011) · Neuroendocrinology · doi:10.1159/000329391 · Cited by 52
“The influence of oral risperidone on bone metabolism has been previously reported. Male patients with schizophrenia treated for at least 1 year with oral risperidone had normal markers of bone remodeling in more than 60p of patients, while BMD at the lumbar region was lower than in healthy subjects [”
BackgroundSkeletal Status in Psychotic Disorders: A Population-Based Study
Partti, K., Heliövaara, M., Impivaara, O., Perälä, J., Saarni, S. I., Lönnqvist, J. K., & Suvisaari, J. (2010) · Psychosomatic Medicine · doi:10.1097/psy.0b013e3181f7abd3 · Cited by 52
“We found significantly lower levels of vitamin D in subjects with schizophrenia, in accordance with the few existing previous studies (3,6,24).”
BackgroundResultZhu, J.-L., Luo, W.-W., Cheng, X., Li, Y., Zhang, Q., & Wen-xing, P. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.112959 · Cited by 51
Osteoporosis, Schizophrenia and Antipsychotics
Halbreich, U. M. (2007) · CNS Drugs · doi:10.2165/00023210-200721080-00003 · Cited by 45
Bushe, C., Yeomans, D., Floyd, T., & Smith, S. M. (2008) · Journal of Psychopharmacology · doi:10.1177/0269881107088436 · Cited by 45
“The relationship between prolactin and bone mineral density (BMD) loss and osteoporosis has been recognised as a putative link for some time, but has been a difficult area in which to arrive at definitive conclusions (Becker et al., 2003; Hummer et al., 2005; Halbreich et al., 2003).”
BackgroundPhysical Illness and Schizophrenia
Leucht, S., Burkard, T., Henderson, J., Maj, M., & Sartorius, N. (2007) · Cambridge University Press eBooks · doi:10.1017/cbo9780511543951 · Cited by 45
Bone Loss Associated with Hyperprolactinemia in Patients with Schizophrenia
Kinon, B. J., Liu‐Seifert, H., Stauffer, V. L., & Jacob, J. (2013) · Clinical Schizophrenia & Related Psychoses · doi:10.3371/csrp.kise.020113 · Cited by 44
Management of Patients Presenting with Acute Psychotic Episodes of Schizophrenia
Thomas, P., Alptekın, K., Gheorghe, M., Mauri, M., Olivares, J. M., & Riedel, M. J. (2009) · CNS Drugs · doi:10.2165/00023210-200923030-00002 · Cited by 45
“In addition, hyperprolactinaemia is a well characterized risk factor for osteoporosis([140-144]) and some, but not all, studies suggest that hyperprolactinaemia may also be associated with a higher risk of breast cancer.”
BackgroundOsteoporosis Associated with Antipsychotic Treatment in Schizophrenia
Wu, H., Deng, L., Zhao, L., Zhao, J., Li, L., & Chen, J. (2013) · International Journal of Endocrinology · doi:10.1155/2013/167138 · Cited by 41
“But the result is in disagreement with several studies of psychiatric patients, which significantly found lower bone mineral density in men than in women associated with neuroleptic use [23, 24].”
ResultGómez, L., Stubbs, B., Ayala, S., Vancampfort, D., Gaughran, F., & Lally, J. (2016) · Current Osteoporosis Reports · doi:10.1007/s11914-016-0325-0 · Cited by 40
Risperidone-induced Symptomatic Hyperprolactinaemia in Adolescents
Holzer, L., & Eap, C. B. (2006) · Journal of Clinical Psychopharmacology · doi:10.1097/01.jcp.0000203194.58087.9a · Cited by 38
“Furthermore, recent concerns regarding the long term-risk of osteoporosis induced by prolactin-raising antipsychotic drugs are emerging.(17,18) In the present report, we describe 5 cases of adolescents treated with risperidone at doses between 0.”
BackgroundBone Density in Chronic Schizophrenia with Long-Term Antipsychotic Treatment: Preliminary Study
Lee, T. Y., Chung, M.-Y., Chung, H.-K., Choi, J., Kim, T. Y., & So, H. (2010) · Psychiatry Investigation · doi:10.4306/pi.2010.7.4.278 · Cited by 38
Schizophrenia: Women Bear a Disproportionate Toll of Antipsychotic Side Effects
Seeman, M. V. (2010) · Journal of the American Psychiatric Nurses Association · doi:10.1177/1078390309350918 · Cited by 37
“In both sexes, the more the weight, the denser the bone (Hummer et al., 2005).”
BackgroundSex differences in schizophrenia: symptomatology, treatment efficacy and adverse effects
Moniem, I., & Kafetzopoulos, V. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1594334 · Cited by 44
Bone Mineral Density and Osteoporosis Risk in Older Patients With Schizophrenia
Jung, D.-U., Kelly, D. L., Oh, M., Kong, B.-G., Kang, J.-W., Lee, S., & Shim, J.-C. (2011) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e318221b123 · Cited by 34
“Male patients with schizophrenia may be afflicted by bone loss differently than women because of an earlier age of illness onset and the lower sociodemographic factors, such as family sup port and care.(12,13) However, little is known regarding low bone density in men with schizophrenia, an area that is deserving of m…”
BackgroundTsai, M., Lee, S.-M., Chen, H., & Wu, B. (2018) · Schizophrenia Research · doi:10.1016/j.schres.2018.01.023 · Cited by 33
Stubbs, B. (2009) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/j.1365-2850.2009.01472.x · Cited by 32
“Osteoporosis is asymptomatic in the absence of fractures but its presence increases susceptibility to fractures (Hummer et al. 2005).”
BackgroundInfluentialKunimatsu, T., Kimura, J., Funabashi, H., Inoue, T., & Seki, T. (2010) · Regulatory Toxicology and Pharmacology · doi:10.1016/j.yrtph.2010.08.001 · Cited by 30
Aichhorn, W., Whitworth, A. B., Weiss, E. M., Hinterhuber, H., & Marksteiner, J. (2006) · Der Nervenarzt · doi:10.1007/s00115-006-2112-0 · Cited by 29
“Hummer und Mitarbeiter fanden niedrigere Knochendichtewerte bei Männern und nur einen statistischen Trend mit der Einnahme prolaktinerhöhender AP [42].”
BackgroundJavaid, M. K., & Holt, R. I. (2008) · Journal of Psychopharmacology · doi:10.1177/0269881107087955 · Cited by 28
Second-generation antipsychotics and bone turnover in schizophrenia
Okita, K., Kanahara, N., Nishimura, M., Yoshida, T., Yasui‐Furukori, N., Niitsu, T., Yoshida, T., Ishikawa, M., Kimura, H., Nomura, F., et al. (2014) · Schizophrenia Research · doi:10.1016/j.schres.2014.05.009 · Cited by 27
“The present resultsmay also shed light on the reports that a subset of patients, but not all patients, presented BMD loss (Hummer et al., 2005; Kishimoto et al., 2008; Lee et al., 2010; Sugawara et al., 2011).”
BackgroundBonnot, O., Inaoui, R., Raffin, M., Bodeau, N., Coussieu, C., & Cohen, D. (2011) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2010.0079 · Cited by 26
“Hummer et al. showed low VDBLs in 50% of 75 patients with schizophrenia (Hummer et al. 2005).”
InfluentialSerum Prolactin and Bone Mineral Density in Schizophrenia: A Systematic Review
Lally, J., Sahl, A. B., Murphy, K. C., Gaughran, F., & Stubbs, B. (2019) · Clinical Psychopharmacology and Neuroscience · doi:10.9758/cpn.2019.17.3.333 · Cited by 24
No association between bone mass and prolactin levels among patients with schizophrenia
Sugawara, N., Yasui‐Furukori, N., Fujii, A., Saito, M., Sato, Y., Nakagami, T., Tsuchimine, S., & Kaneko, S. (2011) · Human Psychopharmacology Clinical and Experimental · doi:10.1002/hup.1250 · Cited by 23
“…a direct effect of prolactin on BMD was not observed, the duration of antipsychotic treatment had a tendency to be associated with decreased BMD (Hummer et al., 2005) and patients with hyperprolactinemia showed higher rates of bone metabolism, including both bone formation and bone resorption…”
BackgroundClozapine protects bone mineral density in female patients with schizophrenia
Lin, C., Huang, K.-H., Chang, Y., Huang, Y., Hsu, W.-C., Lin, C.-Y., Chou, F. H., Tsai, G. E., & Lane, H. (2011) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145711001507 · Cited by 22
“Higher BMI has been found to be associated with increased BMD (Akdeniz et al. 2009; Howes et al. 2005; Hummer et al. 2005; Kim et al. 2008).”
BackgroundAntioch, I., Ciobica, A. S., Paulet, M., Bild, V., Lefter, R. M., & Timofte, D. V. (2015) · PubMed · Cited by 17
Hip, vertebral, and wrist fracture risks and schizophrenia: a nationwide longitudinal study
Chu, Y.-W., Chen, W., Yang, A. C., Tsai, S., Hu, L., Lee, S.-C., Lee, Y., & Shen, C. (2022) · BMC Psychiatry · doi:10.1186/s12888-022-03723-7 · Cited by 17
“[23] concluded that in men but not women with schizophrenia, bone mineral density was significantly lower than normal in the lumbar region.”
BackgroundFalls in older adult psychiatric patients: equipping nurses with knowledge to make a difference
Stubbs, B. (2011) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/j.1365-2850.2010.01686.x · Cited by 16
Jhon, M., Yoo, T., Lee, J., Kim, S., Kim, J., Shin, I., Williams, L. J., Berk, M., Yoon, J., & Kim, S. (2018) · Human Psychopharmacology Clinical and Experimental · doi:10.1002/hup.2648 · Cited by 15
“Several studies of psychiatric patients also reported significantly lower BMDs in men on neuroleptics than in women (Hummer et al., 2005).”
BackgroundBonnot, O., Inaoui, R., Lloret‐Linares, C., & Cohen, D. (2009) · Neuropsychiatrie de l Enfance et de l Adolescence · doi:10.1016/j.neurenf.2009.09.004 · Cited by 13
van der Leeuw, C., Habets, P., Domen, P. A. E., van Kroonenburgh, M. J. P. G., van Os, J., & Marcelis, M. C. (2012) · Schizophrenia Research · doi:10.1016/j.schres.2012.10.031 · Cited by 11
“While there is evidence for decreased BMD specifically in male patients with schizophrenia (Hummer et al., 2005; Lehman and Meyer, 2005; Meyer and Lehman, 2006; Kishimoto et al., 2008), there are also studies suggesting that female patients are particularly vulnerable to compromised skeletal status (Partti et al.”
Hafizi, S., Lix, L. M., Hans, D. B., Bolton, J. M., & Leslie, W. D. (2022) · Bone · doi:10.1016/j.bone.2022.116565 · Cited by 11
Wie viel allgemeinmedizinische Kompetenz benötigen Psychiater?
Hewer, W. (2005) · Der Nervenarzt · doi:10.1007/s00115-005-1881-1 · Cited by 10
The shoulder: taking the strain during restraint
Hollins, L., & Stubbs, B. (2010) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/j.1365-2850.2010.01670.x · Cited by 11
The Effects of Chlorpromazine on Reproductive System and Function in Female Rats.
Zamani, Z., Zare, S., Sadrkhanlou, R., Ahmadi, A., & Movahed, E. (2015) · PubMed Central · doi:10.22074/ijfs.2015.4553 · Cited by 10
“tension, cardiac arrhythmia, and sudden cardiac death (5-9).”
BackgroundBulut, S. D., BULUT, S., Tüzer, V., Ak, M., Ak, E., Kısa, C., Aydemir, Ç., & Göka, E. (2014) · Nöro Psikiyatri Arşivi · doi:10.4274/npa.y6628 · Cited by 10
“In our study, the mean BMI values were found to be above 25 kg/m2 in both groups, and the positive correlation between BMI and BMD is compatible with the other studies in the literature (7,21,26).”
ResultHormonal Risk Factors for Osteoporosis: Different Profile Among Antipsychotics
Raffin, M., Bonnot, O., Giannitelli, M., Xavier, J., Bodeau, N., Bibrac, B., Leban, M., Fautrel, B., Ménard, M.-L., Consoli, A., et al. (2018) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2017.0158 · Cited by 10
“Although the World Health Organization has not already listed antipsychotic medications among risk factors for osteoporosis (Crews and Howes 2012), it is legitimate to wonder whether young patients exposed to SGAs would be at a greater risk.”
InfluentialEffect of age and disease on bone mass in Japanese patients with schizophrenia
Sugawara, N., Yasui‐Furukori, N., Umeda, T., Tsuchimine, S., Fujii, A., Sato, Y., Saito, M., Furukori, H., Danjo, K., Matsuzaka, M., et al. (2012) · Annals of General Psychiatry · doi:10.1186/1744-859x-11-5 · Cited by 9
“Previous studies have reported that QUS parameters cannot be used to predict decreased BMD and that the sensitivities and specificities of QUS parameters are not sufficient to allow it to be used as an alternative to DXA [31-33], which is currently the gold standard for measuring BMD [34,35].”
BackgroundAhire, M., Sheridan, J. S., Regbetz, S., Stacey, P., & Scott, J. G. (2012) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867412450753 · Cited by 8
“, 2001), osteoporosis (Hummer et al., 2005), sexual dysfunction (Smith et al.”
BackgroundPetronijević, N., Sopta, J. P., Doknić, M., Radonjić, N. V., Petronijević, M., Pekić, S., Marić, N. P., Jašović‐Gašić, M., & POPOVIC, V. M. (2013) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2013.05.013 · Cited by 8
Changes in biomarkers of bone turnover in an aripiprazole add-on or switching study
Lodhi, R. J., Masand, S., Malik, A., Shivakumar, K., McAllister, V., O’Keane, V., Young, L. C., Heald, A. H., Sherwood, R. A., & Aitchison, K. J. (2016) · Schizophrenia Research · doi:10.1016/j.schres.2015.12.007 · Cited by 8
Deciphering the skeletal interoceptive circuitry to control bone homeostasis
Wu, Y., Guo, J., Chen, Z., Zhang, F., Chow, B., Chen, Z., Yeung, K., & Qiao, W. (2025) · BMEMat · doi:10.1002/bmm2.12138 · Cited by 6
Zorrilla, I., López-Zurbano, S., Cano, A. I., & González-Pinto, A. M. (2014) · Springer eBooks · doi:10.1007/978-3-319-05870-2_27 · Cited by 6
Psychosis-induced vitamin D deficiency with secondary hyperparathyroidism and osteoporotic fractures
Agorastos, A., Weinås, Å., Agorastos, A. D., & Wiedemann, K. (2011) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2011.05.015 · Cited by 6
Antipsychotic medication use and fracture: a case–control study
Manavi, B. A., Stuart, A. L., Pasco, J. A., Hodge, J. M., Weerasinghe, D. K., Samarasinghe, R. M., & Williams, L. J. (2023) · Scientific Reports · doi:10.1038/s41598-023-40762-w · Cited by 7
“Our findings align with previous studies reporting a higher risk of fracture in men using antipsychotics 16,27,50,51 .”
ResultScreening Men for Osteoporosis: Who & How
Shekelle, P., Munjas, B. A., Liu, H., Wong, E. L., Paige, N. M., Goldzweig, C. L., Zhou, A., & Suttorp, M. J. (2007) · Cited by 6
Geschlechterunterschiede in der neuropsychiatrischen Pharmakotherapie
Regitz‐Zagrosek, V., Schubert, C., & Krüger, S. (2008) · Der Internist · doi:10.1007/s00108-008-2233-6 · Cited by 6
Spezielle Aspekte der pharmakotherapeutischen Behandlung forensisch untergebrachter Patientinnen
Singer, M., & Eckermann, G. (2023) · Forensische Psychiatrie Psychologie Kriminologie · doi:10.1007/s11757-023-00762-y · Cited by 7
Liu, F., Wu, Y., Chen, J., Zou, T., Qin, Y., Teng, Z., Su, Y., Wu, R., & Huang, J. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-04951-1 · Cited by 5
“In line with previous studies [21, 46, 47], male patients were more susceptible to low BMD than female patients.”
ResultŞizofrenide Görülen Tıbbi Durumlar
Demirel, B. D., Tamam, L., & Kara, G. K. (2017) · Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry · doi:10.18863/pgy.288680 · Cited by 5
Taweel, M. E. S. E., & Abdalla, A. M. (2017) · Middle East Current Psychiatry · doi:10.1097/01.xme.0000513069.03258.07 · Cited by 5
Stubbs, B., & Hollins, L. (2011) · Journal of Clinical Nursing · doi:10.1111/j.1365-2702.2011.03738.x · Cited by 5
Antipsychotika und Hyperprolaktinämie: Pathophysiologie, klinische Bedeutung, Abklärung und Therapie
Riecher‐Rössler, A., Schmid, C., Bleuer, S., & Birkhäuser, M. (2009) · Gynäkologische Endokrinologie · doi:10.1007/s10304-009-0316-7 · Cited by 5
Bone mineral density and general health of long-term residential psychiatric inpatients
Hallahan, B. P., Lyons, D., & Doyle, P. (2008) · Irish Journal of Psychological Medicine · doi:10.1017/s0790966700011095 · Cited by 4
“Our results of increased bone loss in the lumbar spine compared to the left hip are consistent with the fact that bone loss typically occurs first in the spine region (92% of cases).(16) High levels of medication (as measured by chlorpromazine equivalents) were associated with high prolactin levels.”
BackgroundResultThe Importance of Screening for Osteoporosis in Mental Health Settings
Miller, M. M. (2009) · Clinical Schizophrenia & Related Psychoses · doi:10.3371/csrp.3.3.4 · Cited by 4
Managing the risks associated with physical intervention: a discussion paper
Hollins, L., & Stubbs, B. (2011) · The British Journal of Forensic Practice · doi:10.1108/14636641111190015 · Cited by 4
“Individuals with osteoporosis or thinning of the bones ( Hummer et al. , 2005”
BackgroundSchizophrenia, Osteoporosis, and an Examination of the Risk of Fractures in Patients Receiving ECT
Andrade, C., Bhakta, S. G., & Singh, N. M. (2007) · Journal of Ect · doi:10.1097/yct.0b013e31814da9c2 · Cited by 3
Mahajan, N. P., Gadod, L. L., Chandanwale, A., S, P. K. G., Narvekar, M. A., & Kamble, M. (2021) · Journal of Orthopaedic Case Reports · doi:10.13107/jocr.2021.v11.i06.2246 · Cited by 3
Goodwin, G. M., Fleischhacker, W., Arango, C., Baumann, P., Davidson, M., Binder, M. D., Falkai, P., Kapur, S., Leucht, S., Licht, R. W., et al. (2011) · Psiquiatría Biológica · doi:10.1016/j.psiq.2011.06.001 · Cited by 3
Self-citationKoçer, E., Yazıcı, S., & Canan, F. (2011) · Dusunen Adam The Journal of Psychiatry and Neurological Sciences · doi:10.5350/dajpn2011240407 · Cited by 3
“There are several studies showing low bone mineral density in chronic schizophrenia patients (14,16,22).”
BackgroundAntipsychotika und Hyperprolaktinämie: Pathophysiologie, klinische Bedeutung, Abklärung und Therapie
Riecher‐Rössler, A., Schmid, C., Bleuer, S., & Birkhäuser, M. (2009) · Neuropsychiatrie · doi:10.5414/nepband23071 · Cited by 3
Osteoporosis and Schizophrenia
LEVINE, J., & Belmaker, R. H. (2006) · American Journal of Psychiatry · doi:10.1176/appi.ajp.163.3.549-a · Cited by 3
Prescriptions d'antipsychotiques chez l'enfant et l'adolescent
Bonnot, O., Consoli, A., & Cohen, D. (2011) · Encyclopédie médico-chirurgicale. Psychiatrie · doi:10.1016/s0246-1072(11)53146-3 · Cited by 2
Kronik Antipsikotik Kullanımının Kemik, Meme ve Serviks Üzerine Etkileri
Bilici, M., Yenel, A., Kavlak, S. Ö., Uz, Y., Sünbül, E. A., & Çiftçi, A. (2011) · Klinik Psikofarmakoloji Bülteni-Bulletin of Clinical Psychopharmacology · doi:10.5455/bcp.20110510114010 · Cited by 2
Evaluation of the link between chronic antipsychotic use and osteoporosis
Downs, R., & Mathys, M. L. (2013) · Mental Health Clinician · doi:10.9740/mhc.n166823 · Cited by 2
The endocrine impact of long term risperidone therapy in Asian Indian patients
Ravan, J. R., Thomas, N., Paul, T. V., Prasanna, S., Thomas, N., & Ramaswamy, D. (2017) · Open Journal of Psychiatry & Allied Sciences · doi:10.5958/2394-2061.2017.00003.9 · Cited by 2
“However, these have been looked at as continuous variables, without categorisation into hyper or hypoprolactinaemic states.[9,18]”
BackgroundOsteopenia and the physical function in Japanese patients with schizophrenia
Uchida, S., Ichinose, T., Iizuka, Y., Okamura, K., Shitara, H., Yamazaki, M., Takagishi, K., & Iizuka, H. (2017) · Archives of Osteoporosis · doi:10.1007/s11657-017-0391-7 · Cited by 2
Complications of neuroleptic hyperprolactinaemia
Mazo, G. E., & Николаевна, Г. Л. (2018) · V M BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY · doi:10.31363/2313-7053-2018-2-104-108 · Cited by 2
Ansari, H., Fung, K., Cheung, A. M., Jaglal, S. B., Bogoch, E. R., & Kurdyak, P. A. (2024) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2024.05.010 · Cited by 2
Antipsychotics and prolactinemia: biological regulation and clinical aspects
Milano, W. D., Rosa, M. D., Milano, L., Nolfe, G., & Petrella, C. (2010) · Giornale italiano di psicopatologia/Journal of psychopathology/Italian journal of psychopathology · Cited by 1
Metadata
- Authors
- Hummer, M., Malik, P., Gasser, R. W., Hofer, A., Kemmler, G., Moncayo Naveda, R. C., Rettenbacher, M. A., & Fleischhacker, W. W.
- Affiliations
- Innsbruck Medical University (AT)
- Venue
- American Journal of Psychiatry
- Published
- 2005-01-01
- Volume
- 162
- Issue
- 1
- Pages
- 162-167
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2110298944
- Cited by
- 125
- References
- 30
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 4 · 2022: 2 · 2021: 4 · 2020: 1 · 2019: 4 · 2018: 6 · 2017: 6 · 2016: 6 · 2015: 7 · 2014: 7 · 2013: 6 · 2012: 7
- FWCI
- 3.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Infectious Diseases › HIV-related health complications and treatments
- Keywords
- osteoporosis, schizophrenia, bone mineral density, antipsychotic drugs, prolactin, sex differences, body mass index, 25-hydroxyvitamin D3, bone metabolism, negative symptoms, bone loss
- MeSH terms
- Adult, Calcifediol, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Osteoporosis, Schizophrenia, Sex Factors, Antipsychotic Agents, Absorptiometry, Photon, Bone Density, Comorbidity, Body Mass Index, Sex Distribution
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