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Previous Volume 335:1176-1181 October 17, 1996 Number 16 Next

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ABSTRACT

Background Depression is associated with alterations in behavior and neuroendocrine systems that are risk factors for decreased bone mineral density. This study was undertaken to determine whether women with past or current major depression have demonstrable decreases in bone density.

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 alleles.

Results As compared with the normal women, the mean (±SD) bone 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 centimeter, 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 lower at Ward's triangle (0.70 ±0.14 vs. 0.81 ±0.13 g per square centimeter, 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, women with past or current depression had higher urinary cortisol excretion (71 ± 29 vs. 51 ± 19 µg per day [196 ± 80 vs. 141 ± 52 nmol per day], P = 0.006), lower serum osteocalcin concentrations (P = 0.04), and lower urinary excretion of deoxypyridinoline (P = 0.02).

Conclusions Past or current depression in women is associated with decreased bone mineral density.

Source Information

From the Clinical Neuroendocrinology Branch, National Institute of Mental Health, Bethesda, Md. (D.M., L.H., E.G., P.G.); the Developmental Endocrinology Branch, National Institute of Child Health and Human Development, Bethesda, Md. (C.S., G.C.); the Division of Genetics, Georgetown University Children's Medical Center, Washington, D.C. (C.S.); and the Department of Nuclear Medicine, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Md. (J.R.).

Address reprint requests to Dr. Michelson at the Warren G. Magnuson Clinical Center, Room 2D 46, MSC 1284, National Institutes of Health, Bethesda, MD 20892-1284.

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