정신분열병 환자의 골밀도 저하 위험요소에 대한 고찰:양성 및 음성 증후군 척도를 중심으로
A Study of Risk Factors Related with Decreased Bone Mineral Density in Patients with Schizophrenia:Focus on Items of Positive and Negative Syndrome Scale
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Objectives:Decreased bone mineral density(BMD) in patients with schizophrenia on antipsychotics has been attributed to a variety of factors such as hyperprolactinemia, low levels physical activities, decreased calcium intake, reduced exposure to sunlight. In this study, we examined the correlation between risk factors causes of decreased BMD in patients with schizophrenia. Methods:We screened 22 patients with schizophrenia who treated with antipsychotics for at least one year. We estimated serum prolactin, sexual hormones, biological markers of bone turnover, epidemiologic factors influencing decreased BMD. And we also examined the correlation of positive and negative syndrome scale(PANSS), lumbar spine and femoral neck BMD. Results:The study subjects have hyperprolactinemia. Among them, 3 subjects showed osteoporosis and 3 subjects showed osteopenia. BMD showed a negative correlation with hallucinatory behavior, emotional withdrawal, passive/apathetic social withdrawal, lack of spontaneity and flow of conversation, disturbance of volition of PANSS and BMI. BMD showed no correlation with serum prolactin, other risk factors of decreased BMD. Conclusion:Decreased BMD observed in patients with schizophrenia correlated with psychopathology of schizophrenia.
Abstract
Objectives:Decreased bone mineral density(BMD) in patients with schizophrenia on antipsychotics has been attributed to a variety of factors such as hyperprolactinemia, low levels physical activities, decreased calcium intake, reduced exposure to sunlight. In this study, we examined the correlation between risk factors causes of decreased BMD in patients with schizophrenia. Methods:We screened 22 patients with schizophrenia who treated with antipsychotics for at least one year. We estimated serum prolactin, sexual hormones, biological markers of bone turnover, epidemiologic factors influencing decreased BMD. And we also examined the correlation of positive and negative syndrome scale(PANSS), lumbar spine and femoral neck BMD. Results:The study subjects have hyperprolactinemia. Among them, 3 subjects showed osteoporosis and 3 subjects showed osteopenia. BMD showed a negative correlation with hallucinatory behavior, emotional withdrawal, passive/apathetic social withdrawal, lack of spontaneity and flow of conversation, disturbance of volition of PANSS and BMI. BMD showed no correlation with serum prolactin, other risk factors of decreased BMD. Conclusion:Decreased BMD observed in patients with schizophrenia correlated with psychopathology of schizophrenia.
참고문헌 (37)
- World Health Organization, "Guideline for preclinical evaluation and clinical trial in osteoporosis" (1998), World Health Organization
- Cooper GS, "Long-term effect of reproductive-age menstrual cycle patterns on peri- and postmenopausal fracture risk", AM J Epidemiol, 145, pp.804~809 (1997)
- Gennari C, "Secondary osteoporosis", Aging, 10, pp.214~224 (1998)
- Kleinberg DL, "Prolactin levels and adverse events in patients treated with risperidone", J Clin Psychopharmacol, 19, pp.57~61 (1999)
- Wudarsky M, "Elevated prolactin in pediatric patients on typical and atypical antipsychotics", J Child Adolesc Psychopharmacol, 9, pp.239~245 (1999)
- O'Keane V, "Antipsychotic drugs: a new risk factor for osteoporosis in young women with schizophrenia?", J Clin Psychopharmacol, 25, pp.26~31 (2005)
- Kishimoto T, "Antipsychotic-induced hyperprolactinemia inhibits the hypothalamo-pituitary-gonadal axis and reduces bone mineraldensity in male patients with schizophrenia", J Clin Psychiatry, 69, pp.385~391 (2008)
- Abraham G, "Osteoporosis demonstrated by dual energy x-ray absorptiometry in chronic schizophrenic patients", Biol Psychiatry, 26, pp.41~54 (1996)
- Howard L, "Risk of hip fracture in patients with a history of schizophrenia", Br J Psychiatry, 190, pp.129~134 (2007)
- Kapur S, "Relationship between dopamine D(2) occupancy, clinical response, and side effects: a double-blind PET study of first-episode schizophrenia", Am J Psychiatry, 157, pp.514~520 (2000)
- Naidoo U, "Hyperprolactinemia and bone mineral density: the potential impact of antipsychotic agents", Psychoneuroendocrinology, 28, pp.97~108 (2003)
- Naliato EC, "Prevalence of osteopenia in men with prolactinoma", J Endocrinol Invest, 28, pp.12~17 (2005)
- Wyszogrodzka-Kucharska A, "Decrease in mineral bone density in schizophrenic patients treated with 2nd generation antipsychotics", Psychiatr Pol, 39, pp.1173~1184 (2005)
- Meaney AM, "Bone mineral density changes over a year in young females with schizophrenia: relationship to medication and endocrine variables", Schizophr Res, 93, pp.136~143 (2007)
- 원승희, "만성 정신분열병 여성에서 고프로락틴혈증과 골밀도 및 골대사 표지의 상관", 생물치료정신의학, 12(2), pp.204~214 (2006), 대한생물치료정신의학회
- Parfitt AM, "Quantum concept of bone remodeling and turnover: implications for the patho-genesis of osteoporosis", Calcif Tissue Int, 28, pp.1~5 (1979)
- Nordin BE, "Nutrition, osteoporosis, and aging", Ann NY Acad Sci, 854, pp.336~351 (1998)
- Kanis J, "Risk factors for hip fracture in men from southern Europe: the MEDOS study. Mediterranean Osteoporosis Study", Osteoporosis, 9, pp.45~54 (1999)
- Misra M, "Effects of psychiatric disorders and psychotropic medications on prolactin and bone metabolism", J Clin Psychiatry, 65, pp.1607~1618 (2004)
- Halbreich U, "Osteoporosis, schizophrenia and antipsychotics: the need for a comprehensive multifactorial evaluation", CNS Drugs, 21, pp.641~657 (2007)
- Hummer M, "Osteoporosis in Patients With Schizophrenia", Am J Psychiatry, 162, pp.162~167 (2005)
- Petty SJ, "Effect of antiepile-ptic medication on bone mineral measures", Neurology, 65, pp.1358~1365 (2005)
- Haney EM, "Association of low bone mineral density with selective serotonin reuptake inhibitor use by older men", Arch Intern Med, 167, pp.1246~1251 (2007)
- Meaney AM, "Effects of long-term prolactin-raising antipsychotic medication on bone mineral density in patients with schizophrenia", Br J Psychiatry, 184, pp.503~508 (2004)
- Becker D, "Risperidone, but not olanzapine, decreases bone mineral density in female premenopausal schizophrenia patients", J Clin Psychiatry, 64, pp.761~766 (2003)
- Roke Y, "Antipsychotic medication in children and adolescents: a descriptive review of the effects on prolactin level and associated side effects", J Child Adolesc Psychopharmacol, 19, pp.403~414 (2009)
- Howes OD, "Bone mineral density and its relationship to prolactin levels in patients taking antipsychotic treatment", J ClinPsychopharmacol, 25, pp.259~261 (2005)
- Abraham G, "Effects of elevated serum prolactin on bone mineral density and bone metabolism in female patients with schizophrenia: a prospective study", Am J Psychiatry, 160, pp.1618~1620 (2003)
- Bergemann N, "High bone turnover but normal bone mineral density in women suffering from schizophrenia", Psychol Med, 38, pp.1195~1201 (2008)
- Acil AA, "The effects of physical exercises to mental state and quality of life in patients with schizophrenia", Health Nurs, 15, pp.808~815 (2008)
- Falloon IR, "Persistent auditory hallucinations: coping mechanisms and implications for management", Psychol Med, 11, pp.329~339 (1981)
- Carter DM, "Patients' strategies for coping with auditory hallucinations", J Nerv Ment Dis, 184, pp.159~164 (1996)
- Karow A, "Subjective view of positive symptomsand quality of life in patients with schizophrenia", Psychiatr Prax, 35, pp.286~293 (2008)
- Bozikas VP, "Community dysfunction in schizophrenia: rate-limiting factors", Prog Neuropsychopharmacol Biol Psychiatry, 30, pp.463~470 (2006)
- Kulhara P, "Positive and negative subtypes of schizophrenia. A follow-up study from India", Schizophr Res, 3, pp.107~116 (1990)
- Hori A, "Symptom classification of schizophrenia changes with the duration of illness", Acta Psychiatr Scand, 99, pp.447~452 (1999)
- Jung DU, "Prevalence of bone mineral density loss in Korean patients with schizophrenia: a crosssectional study", J Clin Psychiatry, 67, pp.1391~1396 (2006)
