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:https://doi.org/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 / School / Research Centre / Research Group:	Faculty of Education, Health & Human Sciences > School of Human Sciences (HUM)
Last Modified:	16 Nov 2016 11:01
URI:	http://gala.gre.ac.uk/id/eprint/11847

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