BONE-MINERAL DENSITY IN WOMEN WITH DEPRESSION

Background Depression is associated with alterations in behavior and n euroendocrine systems that are risk factors for decreased bone mineral density. This study was undertaken to determine whether women with pa st or current major depression have demonstrable decreases in bone den sity. Methods We measured bone mineral density at the hip, spine, and radius in 24 women with past or current major depression and 24 normal women matched for age, body-mass index, menopausal status, and race, using dual-energy x-ray absorptiometry. We also evaluated cortisol and growth hormone secretion, bone metabolism, and vitamin D-receptor all eles. Results AS compared with the normal women, the mean (+/- SD) bon e density in the women with past or current depression was 6.5 percent lower at the spine (1.00 +/- 0.15 vs. 1.07 +/- 0.09 g per square cent imeter, P=0.02), 13.6 percent lower at the femoral neck (0.76 +/- 0.11 vs, 0.88 +/- 0.11 g per square centimeter, P<0.001), 13.6 percent low er at Ward's triangle (0.70 +/- 0.14 vs. 0.81 +/- 0.13 g per square ce ntimeter, P<0.001), and 10.8 percent lower at the trochanter (0.66+/-0 .11 vs. 0.74+/-0.08 g per square centimeter, P<0.001), In addition, wo men with past or current depression had higher urinary cortisol excret ion (71 +/- 29 vs. 51 +/- 19 mu g per day [196 +/- 80 vs. 141 +/- 52 n mol per day], P=0.006), lower serum osteocalcin concentrations (P=0.04 ), and lower urinary excretion of deoxypyridinoline (P=0.02). Conclusi ons Past or current depression in women is associated with decreased b one mineral density (C) 1996, Massachusetts Medical Society.