Decreased Bone Density and Depression
ABSTRACT & COMMENTARY
Source: Schweiger U, et al. Lumbar bone mineral density in patients with major depression: Evidence of increased bone loss at follow-up. Am J Psychiatry 2000;157:118-120.
Several cross-sectional studies have report-ed an association between depression and decreased bone density. The current longitudinal study was undertaken to evaluate possible progression of bone loss and thereby infer causality. Schweiger and colleagues measured lumbar bone density with quantitative computerized tomography in eight depressed patients older than 40 years and 21 controls. The participants were followed for at least 24 months. Bone density at follow-up was significantly decreased for the depressed patients than for the comparison subjects, and to a greater degree for men than for women. Bone density findings were not attributable to age, gender, or baseline bone density.
Comment by Lauren B. Marangell, MD
Although clearly limited by the small sample size, these data are concordant with other studies and underscore the fact that major depression is a biological disorder with important physical sequelae. Schweiger et al correctly note the likely association of neuroendocrine abnormalities in depression as a likely etiology for changes in bone density. Similarly, increases in cortisol have been implicated in hippocampal changes in patients with major depression, a finding that is consistent with the frequent memory complaints noted in the disorder. It is unknown if treatment for depression is able to reverse or slow the effects on bone density, but this is a reasonable hypothesis because many neuroendocrine changes associated with depression normalize with successful resolution of depression.
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