title: Prevalence of depressive symptoms in postmenopausal women with low bone mineral density and/or prevalent vertebral fracture: results from the Multiple Outcomes of Raloxifene Evaluation (MORE) study.
abstract: OBJECTIVE
  To examine the prevalence of depressive symptoms in a cross-sectional study of postmenopausal women with osteoporosis with and without prevalent vertebral fracture.
  
  
  METHODS
  Participants were a subset of English-speaking women (n = 3798, mean age 66.7 yrs) from the Multiple Outcomes of Raloxifene Evaluation trial, who had low bone mineral density (BMD) and/or prevalent vertebral fractures. Vertebral fractures were measured at baseline by radiography using a semiquantitative technique. Depressive symptoms were assessed at baseline using the Geriatric Depression Scale (GDS), a valid and reliable scale for depression screening in elderly patients. Women were considered as probably depressed if > or = 6 symptoms of depression were reported.
  
  
  RESULTS
  Postmenopausal women with prevalent vertebral fracture reported more depressive symptoms as assessed by the GDS than women without prevalent vertebral fracture (1.54 vs 1.26; p = 0.001). There was an absolute increase of 2.5% (p = 0.008) in the prevalence of probable depression (GDS score > or = 6) in women with prevalent fracture compared to those without prevalent fracture. The prevalence of probable depression was 4.1% among women without prevalent vertebral fracture and 6.6% in women with a prevalent vertebral fracture. The prevalence of probable depression was 3-fold higher in women with at least 3 prevalent vertebral fractures compared to women without prevalent fracture (12.8% vs 4.1%; p < 0.001).
  
  
  CONCLUSIONS
  Postmenopausal women with prevalent vertebral fractures had greater prevalence of depressive symptoms and probable depression as assessed by the GDS than women without vertebral fracture with low BMD. The dual diagnosis of depression and osteoporosis may mean worse health outcomes. Patients with prevalent vertebral fractures may be considered not only for interventions that address fracture risk reduction, but also for psychosocial interventions that address depressive symptoms.
authors.affiliation: Cedars Sinai Medical Center, UCLA, Greater Los Angeles Veterans Administration Health System, Los Angeles, California, USA. stuarts@OMCresearch.org
authors.forename: Stuart L
authors.initials: SL
authors.lastname: Silverman
authors.forename: Wei
authors.initials: W
authors.lastname: Shen
authors.forename: Michael E
authors.initials: ME
authors.lastname: Minshall
authors.forename: Sunny
authors.initials: S
authors.lastname: Xie
authors.forename: Kathryn H
authors.initials: KH
authors.lastname: Moses
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000187:drug effects / Q000502:physiology; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D002136:Calcium, Dietary / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D050723:Fractures, Bone / Q000145:classification* / Q000453:epidemiology*; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications* / Q000188:drug therapy / Q000523:psychology; D015995:Prevalence; D011788:Quality of Life; D020849:Raloxifene Hydrochloride / Q000627:therapeutic use; D013124:Spinal Injuries; D016896:Treatment Outcome; D014807:Vitamin D / Q000627:therapeutic use
chemical_list: D050071:Bone Density Conservation Agents; D002136:Calcium, Dietary; D014807:Vitamin D; D020849:Raloxifene Hydrochloride