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Risk of hip fracture in patients with a history of schizophrenia

  • Louise Howard (a1), Graham Kirkwood (a1) and Morven Leese (a1)

Abstract

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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Copyright

Corresponding author

Dr Louise Howard, PO 29, Health Services Research Department, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. Email: l.howard@iop.kcl.ac.uk

Footnotes

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Declaration of interest

None.

Funding detailed in Acknowledgements.

Footnotes

References

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Risk of hip fracture in patients with a history of schizophrenia

  • Louise Howard (a1), Graham Kirkwood (a1) and Morven Leese (a1)

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