Accelerated osteoporosis in psychiatric patients: possible pathophysiological processes.

Osteoporosis, a very prevalent, potentially debilitating disease, is characterized by decreased bone mineral density (BMD). Decreased BMD has recently been reported in patients suffering from several mental disorders, including schizophrenia and major depression. In these patients the accelerated decrease in BMD can be attributed to drug-induced decreases in levels of estrogen and testosterone, to polydipsia and decreased calcium to smoking and alcoholism, and to increased activity of several interleukins as well as to hyperprolactinemia and hypercortisolemia. Several of these processes may be prevented or altered in order to prevent or delay decreased BMD.