Risk of hip fracture in patients with a history of schizophrenia
Open accessAbstract
Background: There is evidence of an association between decreased bone mineral density schizophrenia, and prolactin-raising antipsychotic medication. However, it is not known whether this is clinically significant. Aims: To investigate whether patients with a history of schizophrenia are at increased risk of hip fracture. Method: In a case-control study, we compared cases of ‘hip fracture’ on the General Practice Research Database (n=16 341) with matched controls (n=29 889). Results: Hip fracture was associated with schizophrenia (OR=1.73; 95% CI 1.32-2.28), and prolactin-raising antipsychotics (OR=2.6; 95% CI 2.432.78), in the univariate analysis. In the multivariate analysis, prolactin-raising antipsychotics were independently associated with hip fracture but schizophrenia was not. A significant interaction between gender and antipsychotics was found in the association with hip fracture (P=0.042); OR=2.12 (95% C11.73-2.59)for men, OR=l.93 (95% C11.78-2.10) for women. Conclusions: The association between prolactin-raising antipsychotic medication and hip fracture may have serious implications for public health. Mental health service patients may require preventive measures including dietary and lifestyle advice.
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Other studies have found significant increases (OR=1.2-2.6) in the risk of fractures associated with antipsychotics.
“Other studies (506-510) have found significant increases (OR=1.2-2.6) in the risk of fractures associated with AP.”
From Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care (2011) · cites this paper as [506]
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ResultA review of the association between antipsychotic use and hyperprolactinaemia
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“Somewhat opposing results were obtained in a case–control study using the General Practice Research Database in the UK, which compared 16 341 hip fracture cases with 29 889 matched controls [46].”
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BackgroundInfluentialHyperprolactinemia in antipsychotic-naive patients with first-episode psychosis
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“…hyperprolactinemia 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…”
BackgroundCookson, J., Hodgson, R. E., & Wildgust, H. J. (2012) · Journal of Psychopharmacology · doi:10.1177/0269881112442016 · Cited by 97 · see citing works
“Howard et al. (2007), using the General Practice Research Database, showed that prolactin-raising antipsychotics are independently associated with hip fractures in schizophrenia.”
MethodA meta-analysis of prevalence estimates and moderators of low bone mass in people with schizophrenia
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“These factors may explain why two recent, large population-cohort studies (17, 18) found that people with schizophrenia are at significantly increased risk of hip fractures compared to the general population.”
BackgroundAntipsychotics and hyperprolactinaemia: Clinical recommendations
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“Such patients are at higher risk of a range of physical diseases (Brown et al., 2000; Dalton et al., 2005; Osborn et al., 2007; Howard et al., 2007), and tend to find it harder to access appropriate physical health care.”
BackgroundSelf-citationAntipsychotics and hyperprolactinaemia: mechanisms, consequences and management
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BackgroundHyperprolactinaemia in early psychosis—not only due to antipsychotics
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“When chronic, it can cause osteopenia and osteoporosis (O'Keane and Meaney, 2005) and increase the risk of bone fractures (Howard et al., 2007).”
Antipsychotic use and the risk of hip/femur fracture: a population-based case–control study
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Review: Cancer and schizophrenia: is there a paradox?
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“Initially, hyperprolactinaemia was an occult side effect but it is now recognized as a cause of amenorrhoea, galactorrhoea, sexual dysfunction, and osteoporosis and bone fractures (Abel et al., 2008; Howard et al., 2007; Kohen and Wildgust, 2008).”
BackgroundProlactin awareness: An essential consideration for physical health in schizophrenia
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“More recently, a case-control study investigated whether potential antipsychotic-induced decreases in bone mineral density could confer an increased risk of hip fractures in patients with a history of schizophrenia (Howard et al., 2007).”
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Risk of osteoporosis and fracture incidence in patients on antipsychotic medication
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“Another large case-control study also using data from the GPRD in the UK revealed a threefold increase in the incidence of hip fractures in patients treated with antipsychotics who experienced elevated prolactin levels [5].”
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“There is, however, evidence that fracture rates are higher in patients taking antipsychotic drugs (Howard et al., 2007).”
BackgroundEffects of Antipsychotics on Bone Mineral Density in Patients with Schizophrenia: Gender Differences
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“differentiated between mild (<50), moderate (50-100) and severe (>100) ng/mL”
BackgroundBone Mineral Density in Schizophrenia
Tseng, P., Chen, Y., Yeh, P., Tu, K.-Y., Cheng, Y., & Wu, C.-K. (2015) · Medicine · doi:10.1097/md.0000000000001967 · Cited by 55 · see citing works
Schizophrenia, antipsychotics and risk of hip fracture: A population-based analysis
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“A large UK based study found that schizophrenia and prolactin-increasing antipsychotics were associated with increased risk of hip fracture in univariate analyses but in light of a strong association with prolactin-increasing antipsychotics, the effect of schizophrenia did not remain significant (Howard et al., 2007).”
BackgroundResultInfluentialAntipsychotic-Induced Hyperprolactinemia
Johnsen, E., Kroken, R. A., Abaza, M., Olberg, H. K., & Jørgensen, H. A. (2008) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e31818ba5d8 · Cited by 53 · see citing works
“In this regard, the evidence seems to be strongest for osteoporosis and hip fractures.(11,12) There is also evidence of links to mammary carcinoma(13) as well as emerging evidence connecting hyperprolactinemia to endometrial cancer.”
BackgroundRisk and outcomes for traumatic brain injury in patients with mental disorders
Liao, C., Chiu, W., Yeh, C.-C., Chang, H., & Chen, T.-L. (2012) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2012-302337 · Cited by 53 · see citing works
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“Therefore, the increasing awareness of the effect of antipsychotics on bone metabolism may prompt clinicians to screen patients at high risk of antipsychotic-induced osteoporosis and reduce the incidence of potentially avoidable fractures (Howard et al., 2007; Renn et al., 2009; Partti et al., 2010; Graham et al., 201…”
BackgroundGomes, E., Bastos, T. C. L., Probst, M., Ribeiro, J. C., Silva, G., & Corredeira, R. (2014) · Mental health and physical activity · doi:10.1016/j.mhpa.2014.07.002 · Cited by 52 · see citing works
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Kelly, D. L., Wehring, H. J., Earl, A. K., Sullivan, K. M., Dickerson, F., Feldman, S. M., McMahon, R. P., Buchanan, R. W., Warfel, D. T., Keller, W. R., et al. (2013) · BMC Psychiatry · doi:10.1186/1471-244x-13-214 · Cited by 45 · see citing works
“Bone fractures occur more frequently in people with schizophrenia taking antipsychotics than in the nonpsychiatric population [77,78].”
BackgroundUltrasound bone mass in schizophrenic patients on antipsychotic therapy
Rey‐Sánchez, P., García, J. M. L., Canal-Macías, M. L., Gomez-Zubeldia, M. A., Roncero‐Martín, R., & Pedrera‐Zamorano, J. D. (2008) · Human Psychopharmacology Clinical and Experimental · doi:10.1002/hup.984 · Cited by 45 · see citing works
Bushe, C., Yeomans, D., Floyd, T., & Smith, S. M. (2008) · Journal of Psychopharmacology · doi:10.1177/0269881107088436 · Cited by 45 · see citing works
“Recent reports link hyperprolactinaemia to hip fractures resulting from osteoporosis, breast cancer and pituitary tumours (Howard et al., 2007; Szarfman et al., 2006; Tworoger et al., 2007; Tworoger and Hankinson, 2006; Tworoger et al., 2006, Tworoger et al., 2004, Harvey et al., 2008).”
BackgroundVijeepallam, K., Pandy, V., Kunasegaran, T., Murugan, D. D., & Naidu, M. K. (2016) · Frontiers in Pharmacology · doi:10.3389/fphar.2016.00464 · Cited by 43 · see citing works
“For example, extrapyramidal motor disturbances such as acute dystonia and tardive dyskinesia are commonly observed with typical antipsychotics whereas weight gain, ventricular arrhythmias, agranulocytosis are some of the common adverse effects of atypical antipsychotics (Howard et al., 2007).”
BackgroundMethodRoke, Y., van Harten, P. N., Buitelaar, J. K., Tenback, D. E., Quekel, L. G. B. A., de Rijke, Y. B., & Boot, A. M. (2012) · European Journal of Endocrinology · doi:10.1530/eje-12-0521 · Cited by 43 · see citing works
Panula, J., Puustinen, J., Jaatinen, P. T., Vahlberg, T. J., Aarnio, P. T. T., & Kivelä, S. (2009) · Drugs & Aging · doi:10.2165/11317660-000000000-00000 · Cited by 41 · see citing works
Osteoporosis 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 · see citing works
“Furthermore, a large case control analysis, including 22,250 hip/femur fractures with an equal number of controls, provided evidence that patients on antipsychotics were at an increased risk of hip/femur fractures, regardless of the antipsychotic drug prescribed [16].”
BackgroundSpanish consensus on the risks and detection of antipsychotic drug-related hyperprolactinaemia
Montejo, A. L., Arango, C., Bernardo, M., Carrasco, J. L., Crespo‐Facorro, B., Cruz, J. J., del Pino, J., Escudero, M. A. G., García‐Rizo, C., González-Pinto, A. M., et al. (2016) · Revista de Psiquiatría y Salud Mental (English Edition) · doi:10.1016/j.rpsmen.2016.06.001 · Cited by 40 · see citing works
Gómez, 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 · see citing works
Tsai, K., Lee, C., Chou, Y.-M., Shen, S., Su, C., Wu, H., Huang, M., Shie, J.-P., & Chou, F. H. (2014) · Schizophrenia Research · doi:10.1016/j.schres.2014.09.032 · Cited by 38 · see citing works
“In a case–control study, Howard et al. (2007) found that psychiatric drugs (neuroleptics, SSRIs, anticonvulsants, tricyclic antidepressants, and hypnotics) were independently associatedwith hip fractures; however, schizophrenia as a diseasewas not associatedwith hip fractures.”
InfluentialRoke, Y., van Harten, P. N., Franke, B., Galesloot, T. E., Boot, A. M., & Buitelaar, J. K. (2013) · Pharmacogenetics and Genomics · doi:10.1097/fpc.0b013e3283647c33 · Cited by 40 · see citing works
Bone 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 · see citing works
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 38 · see citing works
“This is a problem for the elderly, regardless of sex, but may place women at extra risk for fracture because of their greater likelihood of suffering from osteoporosis (Howard et al., 2007; Vester gaard, Rejnmark, & Mosekilde, 2006).”
BackgroundInfluentialWand, T., & Murray, L. (2008) · International Journal of Mental Health Nursing · doi:10.1111/j.1447-0349.2008.00559.x · Cited by 36 · see citing works
Antipsychotic drug exposure and risk of fracture
Papola, D., Ostuzzi, G., Thabane, L., Guyatt, G. H., & Barbui, C. (2018) · International Clinical Psychopharmacology · doi:10.1097/yic.0000000000000221 · Cited by 35 · see citing works
Use of proton pump inhibitors and risk of fragility hip fracture in a Mediterranean region
Reyes, C., Formiga, F., Coderch, M., Hoyo, J., Férriz, G., Casanovas, J., Monteserín, R., Brotons, C., Rojas, M., & Moral, I. (2012) · Bone · doi:10.1016/j.bone.2012.09.028 · Cited by 34 · see citing works
“Some studies associate the antipsychotic medication with an increase of prolactin levels and the appearance of hypogonadism [17], however the number of”
BackgroundBone 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 · see citing works
Bipolar disorder and the risk of fracture: A nationwide population-based cohort study
Su, J., Cheng, B.-H., Huang, Y.-C., Lee, C.-P., Yang, Y., Lu, M., Hsu, C., Lee, Y. L., McIntyre, R. S., Lin, T. C., et al. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.04.037 · Cited by 33 · see citing works
“Studies have also reported that schizophrenia is not associated with increased risk of fracture however, schizophrenic drug prescription of prolactin-elevating antipsychotics have been reported to be independently associated with increased risk of hip fracture (Howard et al., 2007).”
BackgroundSocioeconomic deprivation and associated risk factors of traumatic brain injury in children
Liao, C., Chang, H., Yeh, C.-C., Chou, Y.-C., Chiu, W., & Chen, T.-L. (2012) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/ta.0b013e31826fc87f · Cited by 33 · see citing works
Murray, C. (2012) · The British Journal of Social Work · doi:10.1093/bjsw/bcs054 · Cited by 32 · see citing works
Kelly, D. L., Powell, M. M., Wehring, H. J., Sayer, M. A., Kearns, A. M., Hackman, A. L., Buchanan, R. W., Nichols, R., Adams, H. A., Richardson, C. M., et al. (2018) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000000898 · Cited by 32 · see citing works
Positioning mental health nursing practice within a positive health paradigm
Wand, T. (2012) · International Journal of Mental Health Nursing · doi:10.1111/j.1447-0349.2012.00848.x · Cited by 31 · see citing works
“Consequently, associations have been found between the long-term use of prolactin-raising antipsychotic medications and hip fractures (Howard et al. 2007).”
BackgroundBushe, C., Sniadecki, J. L., Bradley, A., & Hoffmann, V. P. (2009) · Journal of Psychopharmacology · doi:10.1177/0269881108101783 · Cited by 31 · see citing works
Stubbs, B. (2009) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/j.1365-2850.2009.01472.x · Cited by 31 · see citing works
“Irrespective of the particular illness, those with severe and enduring mental illness are at risk of osteoporosis (Howard et al. 2007).”
BackgroundInfluentialMinireview: A Skeleton in Serotonin’s Closet?
Kawai, M., & Rosen, C. J. (2010) · Endocrinology · doi:10.1210/en.2010-0499 · Cited by 29 · see citing works
Patient Falls and Injuries in U.S. Psychiatric Care: Incidence and Trends
Turner, K. L., Bjarnadóttir, R. I., Jo, A., Repique, R. J. R., Thomas, J., Green, J. F., & Staggs, V. S. (2020) · Psychiatric Services · doi:10.1176/appi.ps.202000004 · Cited by 29 · see citing works
Javaid, M. K., & Holt, R. I. (2008) · Journal of Psychopharmacology · doi:10.1177/0269881107087955 · Cited by 28 · see citing works
“…GPRD), among those with a diagnosis of hip fracture (mean age 79 years, reflecting an older group of patients), there was a higher odds ratio of having a diagnosis of schizophrenia [OR 1.73 (1.32–2.28)] as well as having being prescribed an antipsychotic [OR 2.60 (2.43–2.78)] (Howard et al., 2007).”
BackgroundInfluentialPérez‐Iglesias, R., Mata, I. F., Martínez‐García, O., García‐Unzueta, M. T., Amado, J., Valdizán, E. M., Vázquez‐Barquero, J. L., & Crespo‐Facorro, B. (2012) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e318272688b · Cited by 27 · see citing works
“Longterm hypogonadism due to hyperprolactinemia has been associated with osteoporosis(4) and hip fracture.(5) Preclinical animal models indicate that prolonged high levels of prolactin may predispose to breast cancer; however, clinical data are limited and inconclusive.”
BackgroundDevelopment of the Edmonson Psychiatric Fall Risk Assessment Tool
Edmonson, D., Robinson, S. B., & Hughes, L. F. (2010) · Journal of Psychosocial Nursing and Mental Health Services · doi:10.3928/02793695-20101202-03 · Cited by 27 · see citing works
Bonnot, 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 · see citing works
“In a hospital database of 16,341 patients with hip fractures, Howard et al. (2007) showed that relative risk for hip fracture in the elderly was twice as high in patients with history of antipsychotic treatment compared with patients matched in age, sex, and medical history who had not been treated…”
Antipsychotic Drugs and Risk of Hip Fracture in People Aged 60 and Older in Norway
Bakken, M. S., Schjøtt, J. D., Engeland, A., Engesaeter, L. B., & Ruths, S. (2016) · Journal of the American Geriatrics Society · doi:10.1111/jgs.14162 · Cited by 25 · see citing works
“Although SGAs have fewer adverse side effects than FGAs in terms of sedation and parkinsonism, these drugs are associated with greater risks of cerebrovascular and cardiovascular events and mortality;(14) in the last decade, associations have also been found with hip fractures.(13,42,43) The current results suggest th…”
BackgroundResultGivens, C. (2016) · Nursing Clinics of North America · doi:10.1016/j.cnur.2016.01.013 · Cited by 25 · see citing works
Serum 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 · see citing works
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 · see citing works
“People taking antipsychotic medications have also been shown to be at risk for osteoporosis (Howard et al., 2007).”
BackgroundPrevention Inherent in Services for Women with Schizophrenia
Seeman, M. V. (2008) · The Canadian Journal of Psychiatry · doi:10.1177/070674370805300508 · Cited by 22 · see citing works
Utilisation des antipsychotiques chez l’enfant et l’adolescent
Bonnot, O., & Holzer, L. (2011) · Neuropsychiatrie de l Enfance et de l Adolescence · doi:10.1016/j.neurenf.2011.07.003 · Cited by 21 · see citing works
Incidence and prevalence of medication-induced osteoporosis: evidence-based review
Allport, J. (2008) · Current Opinion in Rheumatology · doi:10.1097/bor.0b013e3282ff0d6d · Cited by 20 · see citing works
Besag, F., Vasey, M. J., & Salim, I. (2021) · CNS Drugs · doi:10.1007/s40263-021-00812-1 · Cited by 19 · see citing works
Injury risk and severity in a sample of Maryland residents with serious mental illness
McGinty, E. E., Baker, S. P., Steinwachs, D. M., & Daumit, G. L. (2012) · Injury Prevention · doi:10.1136/injuryprev-2011-040309 · Cited by 19 · see citing works
Banham-Hall, N., Kothwal, K., Pipkin, J., Bentley, J., & Dickens, G. L. (2013) · Physiotherapy · doi:10.1016/j.physio.2012.12.009 · Cited by 19 · see citing works
Determining the Incidence of Adult Fractures: How Accurate Are Emergency Department Data?
Aitken, S. A., Rodrigues, M. A., Duckworth, A. D., Clement, N. D., McQueen, M. M., & Court-Brown, C. M. (2012) · Epidemiology Research International · doi:10.1155/2012/837928 · Cited by 19 · see citing works
The atypical anti-psychotic clozapine decreases bone mass in rats in vivo
Costa, J. L., Smith, G. C., Watson, M., Lin, J., Callon, K. E., Gamble, G. D., Cheng, A., Vickers, M. H., Shepherd, P. R., Cornish, J., et al. (2010) · Schizophrenia Research · doi:10.1016/j.schres.2010.11.024 · Cited by 17 · see citing works
“Observational studies suggest that schizophrenia and/or its treatment is associated with decreased bone mineral density (BMD) and increased fracture risk (Halbreich et al., 1995; Howard et al., 2006; Hugenholtz et al., 2005; Pouwels et al., 2009).”
BackgroundResultInfluentialHyperprolactinaemia During Treatment With Paliperidone
Skopek, M., & Manoj, P. (2010) · Australasian Psychiatry · doi:10.3109/10398561003686763 · Cited by 17 · see citing works
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 16 · see citing works
Falls 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 · see citing works
The evolution of hyperprolactinaemia as an entity in psychiatric patients
Kohen, D., & Wildgust, H. J. (2008) · Journal of Psychopharmacology · doi:10.1177/0269216307087147 · Cited by 15 · see citing works
“Using the General Practice Research Database, Howard et al. (2007) showed that prolactin-raising antipsychotics are independently associated with hip fractures in schizophrenia (OR=2.6; 95% CI 2.43–2.78) and this has serious implications for public health.”
MethodInfluentialBonnot, 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 · see citing works
Cui, Z., Meng, X., Zhuang, S., Liu, Z., Zhou, F., & Tian, Y. (2019) · Calcified Tissue International · doi:10.1007/s00223-019-00625-x · Cited by 13 · see citing works
Factors associated with decreased bone mineral density in postmenopausal women with schizophrenia
Liang, Y., Huang, J. V., Tian, J., Cao, Y., Zhang, G., Wang, C., Cao, Y., & Li, J. (2016) · Clinical Interventions in Aging · doi:10.2147/cia.s100274 · Cited by 13 · see citing works
“2,3 This issue has approximately doubled the risk of femoral neck fractures in patients with schizophrenia compared with the normal population, 4,5 as well as increased rates of morbidity and mortality, which place a heavy economic burden on society.”
Kim, S., Jeong, J., Um, Y. H., Kim, T., Seo, H., & Hong, S. (2023) · Clinical Psychopharmacology and Neuroscience · doi:10.9758/cpn.23.1057 · Cited by 12 · see citing works
“Severe hyperprolactinemia ( ＞ 100 ng/ml) has been re-ported to increase the risk of osteoporosis and, some cancers (breast cancer, endometrial cancer, etc.) and cardiovascular disease when it is persistent long-term hyper-prolactinemia [25,26].”
BackgroundWomen and schizophrenia: new findings
Seeman, M. V. (2013) · Neuropsychiatry · doi:10.2217/npy.13.55 · Cited by 12 · see citing works
Atypical Antipsychotics and the Risk of Falls and Fractures Among Older Adults
Ramcharran, D., Qiu, H., Schuemie, M. J., & Ryan, P. B. (2017) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000000647 · Cited by 12 · see citing works
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 · see citing works
“In the literature, there is a large body of work reporting significant negative associations between first-generation AP and BMD (Bilici et al., 2002; Meaney et al., 2004; Howard et al., 2007; Kishimoto et al., 2008).”
Effect of risperidone on proliferation and apoptosis of MC3T3-E1 cells
Zheng, L., Yang, L., Zhao, X., Long, N., Li, P., & Wang, Y. (2019) · Brazilian Journal of Medical and Biological Research · doi:10.1590/1414-431x20188098 · Cited by 11 · see citing works
“The rate of femoral neck fracture in patients taking risperidone is more than two-fold that of the normal population, and it may cause the death of patients (4,5).”
BackgroundStubbs, B., Knight, C., & Yorston, G. A. (2008) · International Journal of Therapy and Rehabilitation · doi:10.12968/ijtr.2008.15.1.27944 · Cited by 11 · see citing works
- Authors
- Howard, L., Kirkwood, G., & Leese, M.
- Affiliations
- King's College London (GB)
- Corresponding author
- Howard, Louise
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2007-02
- Volume
- 190
- Issue
- 2
- Pages
- 129-134
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2166620991
- Cited by
- 158
- References
- 29
- Citations by year
- 2026: 2 · 2024: 6 · 2023: 4 · 2022: 2 · 2021: 8 · 2020: 4 · 2019: 6 · 2018: 6 · 2017: 4 · 2016: 11 · 2015: 5 · 2014: 11 · 2013: 15 · 2012: 15
- FWCI
- 9.19
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- 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 › Pediatrics, Perinatology and Child Health › Pharmacological Effects and Toxicity Studies
- Keywords
- hip fracture, schizophrenia, bone mineral density, fracture risk, sex differences, fracture prevention, psychiatric patients
- MeSH terms
- Accidental Falls, Female, Hip Fractures, Humans, Male, Prolactin, Risk Factors, Schizophrenia, Antipsychotic Agents, Bone Density, Case-Control Studies
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