Osteoporosis risk increased in women with psychosis and SUD
MedWire News: Women with psychosis who also have a substance use disorder (SUD) and those with a major mood disorder are at significantly increased risk for osteoporosis, research shows.
"People with schizophrenia are considered a high-risk group for developing bone loss and osteoporosis, due in part to the illness itself and to multiple associated risk factors such as poor diet, low exercise, early menopause, and antipsychotic associated hyperprolactinemia," explain Deanna Kelly (University of Maryland School of Medicine, Baltimore, USA) and colleagues.
"There is also evidence that osteoporosis and bone loss is greater in people who are smokers and who are substance abusing, both common in persons with psychotic disorders," they add.
To investigate the prevalence of, and frequency of screening for osteoporosis among women with psychotic disorders, SUDs, and nonpsychotic major mood disorders, Kelly and team examined data from a Medicaid administrative database.
Among 18,953 women aged 50-64 years during 2005, 2143 (11.3%) had a psychosis diagnosis, 704 (3.7%) had a mood disorder, and 1366 (7.2%) had a SUD. The remainder acted as a control group.
The researchers found that 6.7% of the women had osteoporosis at the time the study, but only 4.0% of those without osteoporosis received screening.
There was no significant difference in osteoporosis screening rates among women with psychosis, major mood disorders, and the control group. Those with a SUD, however, were a significant 39% less likely to receive screening relative to controls.
"We could not determine whether this reduction in screening occurs because clinicians fail to recommend the test to this population, because patients fail to follow-up on that recommendation, or due to other factors," say the researchers.
Women with a major mood disorder and those in the oldest age group (55-64 years) who were dually diagnosed with SUD and psychosis were a significant 1.37 and 6.40 times more likely, respectively, to have osteoporosis than controls.
In contrast, women with psychosis alone or an SUD alone had a similar osteoporosis prevalence to the control group. "Accordingly, it appears that efforts should be made to increase osteoporosis prevention and treatment in those with substance abuse problems and especially in those who also have comorbid psychosis," write Kelly and co-authors in the journal Osteoporosis International.
"The higher rates of diagnosed osteoporosis among older women with major mood disorders indicate that this group, also, may require more extensive screening," they conclude.
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