ABSTRACT
Major Depression is associated with alterations in the neuroendocrine system, dysfunction of hypothalamic-pituitary-adrenal axis, and elevated blood cortisol levels. These changes may result in an increased risk of osteoporosis in depressed patients. The aim was studying the relationship between bone density and major depression. In a historical cohort study, we performed bone densitometry in 75 persons; 25 of them suffered from major depression, the remaining 50 were healthy volunteers as controls. The groups were matched for age, sex, BMI, supplemental calcium intake, regular exercise and menstrual status. Bone mineral density [BMD] was measured by the DXA method. The two groups were compared regarding T-score and BMD of lumbar and pelvic regions. BMD [gr/cm[2]] of total femur, femoral neck, and lumbar regions were all significantly lower in cases than controls, [0.94 +/- 0.13 versus 1.16 +/- 0.15, 0.92 +/- 0.12 versus 1.09 +/- 0.14, and 1.05 +/- 0.22 versus 1.32 +/- 0.21, respectively]. Osteoporosis was more frequent in patients with depression than in controls, 32% versus 4% in total femur region [Odds ratio: 5.4, CI 95%: 1.4%-20.3%], and 36% versus 14% in lumbar region [Odds ratio: 3.5, CI 95%: 1.1%-10.8%]. In this study major depression was associated with lower bone density and increased frequency of osteoporosis. Based on these findings, it seems reasonable to advice that patients with depression should be screened for osteoporosis