One difference between the two groups of women was that the women with depression were taking antidepressants. A previous study suggested that SSRI antidepressants may contribute to bone fractures, but this study showed no link between low bone mass and use of SSRIs.
No significant link was found between the amount of bone loss and severity of depression or the number of depressive episodes.
National Institute of Mental Health Deputy Director Richard Nakamura, PhD, commented:
“Osteoporosis is a silent disease. Too often, the first symptom a clinician sees is when a patient shows up with a broken bone. Now we know that depression can serve as a red flag – that depressed women are more likely than other women to approach menopause already at higher risk of fractures.”
Study author Cizza raised the excellent point,
“Depression generally isn’t on clinicians’ radar screens as a major risk factor for osteoporosis, particularly for premenopausal women. It should be.”
Study conclusions:
"Low BMD is more prevalent in premenopausal women with MDD (major depressive disorder). The BMD deficits are of clinical significance and comparable in magnitude to those resulting from established risk factors for osteoporosis, such as smoking and reduced calcium intake. The possible contribution of immune or inflammatory imbalance to low BMD in premenopausal women with MDD remains to be clarified."1
Summary and comments:
This study showed a clear connection between depression and bone loss (osteoporosis) in women. Given these results, women with depression would be wise to take pre-emptive measures:
- Discuss modifiable risk factors with your doctor and take appropriate action. These risk factors include dietary calcium, lack of exercise, alcohol and caffeine consumption, use of oral contraceptives, and smoking.
- Know your family medical history and tell your doctor about any family history of osteoporosis.
- Talk to your doctor about bone density screening.
This connection between depression and osteoporosis in women is further proof that healthcare needs to be more holistic, and doctors should be screening for depression just as they screen for other diseases.
