title: Risk of hip fracture in patients with a history of schizophrenia.
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.
  
  
  OBJECTIVE
  To investigate whether patients with a history of schizophrenia are at increased risk of hip fracture.
  
  
  METHODS
  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 2.43-2.78), 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 foundinthe association with hip fracture (P=0.042); OR=2.12 (95% CI1.73-2.59) for men, OR=1.93 (95% CI1.78-2.10) 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.
authors.affiliation: Health Services Research Department, Institute of Psychiatry, King's College London SE5 8AF, UK. l.howard@iop.kcl.ac.uk
authors.forename: Louise
authors.initials: L
authors.lastname: Howard
authors.forename: Graham
authors.initials: G
authors.lastname: Kirkwood
authors.forename: Morven
authors.initials: M
authors.lastname: Leese
mesh_terms: D000058:Accidental Falls; D014150:Antipsychotic Agents / Q000009:adverse effects*; D015519:Bone Density / Q000187:drug effects*; D016022:Case-Control Studies; D005260:Female; D006620:Hip Fractures / Q000139:chemically induced*; D006801:Humans; D008297:Male; D011388:Prolactin / Q000187:drug effects*; D012307:Risk Factors; D012559:Schizophrenia / Q000188:drug therapy*
chemical_list: D014150:Antipsychotic Agents; D011388:Prolactin