Treatment of Comorbid Schizophrenia in an Adolescent with Osteogenesis Imperfecta: A Case Report

Osteogenesis imperfecta (OI) is a rare connective tissue disorder characterized by bone fragility, growth retardation, hearing loss, and short stature. Literature on the comorbidity of OI and psychotic disorders is limited. Antipsychotic side effects such as hyperprolactinemia, sedation, and orthostatic hypotension may increase fracture risk, presenting challenges in comorbid cases. Here, we describe a 14-year-old male with OI and schizophrenia. The patient presented with a three-month history of irritability, self-harm, auditory hallucinations, and referential delusions. His history included multiple fractures, leading to OI diagnosis at age 8. He was admitted with acute psychotic disorder and treated with aripiprazole 20 mg/day, resulting in significant symptom improvement. No new bone fractures were observed during one year of follow-up. This case highlights the management of comorbid OI and schizophrenia. Fracture risk is a critical concern in OI patients. Clinicians should carefully select antipsychotics in the presence of psychosis and closely monitor patients to minimize adverse effects.