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

A 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. and Vancampfort, D. (2014) A meta-analysis of prevalence estimates and moderators of low bone mass in people with schizophrenia. Acta Psychiatrica Scandinavica, 130 (6). pp. 470-486. ISSN 0001-690X (Print), 1600-0447 (Online) (doi:10.1111/acps.12313)

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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.

Item Type: Article
Additional Information: This is the accepted version of the following article: Stubbs B, De Hert M, Sepehry AA, Correll CU, Mitchell AJ, Soundy A, Detraux J, Vancampfort D. A meta-analysis of prevalence estimates and moderators of low bone mass in people with schizophrenia, which has been published in final form at http://dx.doi.org/10.1111/acps.12313. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Uncontrolled Keywords: bone mineral density, bone mass, osteoporosis, osteopenia, schizophrenia, physical health, antipsychotics, meta-analysis, hyperprolactinemia, screening
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RZ Other systems of medicine
Faculty / Department / Research Group: Faculty of Education & Health > Department of Psychology, Social Work & Counselling
Last Modified: 16 Nov 2016 11:01
Selected for GREAT 2016: None
Selected for GREAT 2017: None
Selected for GREAT 2018: None
URI: http://gala.gre.ac.uk/id/eprint/11847

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