Severe Mental Illness Linked to Increased Fragility Fracture Risk and Potentially Undiagnosed Osteoporosis

A new study from University College London highlights a critical link between severe mental illness (SMI) and an elevated risk of fragility fractures among individuals over 50. While fragility fractures often signal underlying osteoporosis, the research found that those with SMI are less likely to receive an osteoporosis diagnosis, potentially missing essential preventative care. These findings suggest a significant gap in the diagnosis and management of bone health in this vulnerable population.

The study, published in the British Journal of General Practice, analyzed primary care records of over 440,000 patients over 18 years, focusing on individuals diagnosed with schizophrenia, bipolar disorder, and other psychoses. Results revealed that people with SMI have a markedly higher incidence of fragility fractures—a fracture from a minor fall or impact—compared to the general population, suggesting an underlying osteoporosis risk. In particular, men with SMI were found to be twice as likely to experience a fragility fracture without a corresponding osteoporosis diagnosis. Women with SMI aged 50–54 and those over 80 similarly showed a higher rate of fractures relative to osteoporosis diagnoses.

These findings underscore a critical gap in healthcare for people with SMI, a population already burdened with multiple chronic health conditions, including diabetes, COPD, and cardiovascular diseases. Lead author Dr. Christina Avgerinou suggests that this gap may stem from a combination of factors: lower awareness of osteoporosis among those with SMI, competing medical priorities in primary care, and reduced engagement in physical health check-ups within this group. Additionally, some individuals with SMI may develop osteoporosis at younger ages, further complicating detection.

The study advocates for increased attention to bone health in SMI patients through targeted interventions, such as bone density measurements, pharmacological treatments, and lifestyle adjustments. Addressing this gap could reduce fracture risk and improve long-term health outcomes for individuals with SMI, who already face disproportionately high rates of premature mortality.