title: The association between depressive and anxiety symptoms and bone mineral density in the general population: the HUNT Study.
abstract: BACKGROUND
  Psychiatric disorders may be risk factors for reduced bone mineral density (BMD). Longitudinal evidence is limited and this is yet to be examined among community-dwelling adults with anxiety. We aimed to investigate the cross-sectional and longitudinal relationships between anxiety and depressive symptoms and BMD.
  
  
  METHODS
  This study examined data from the second Nord-Trondelag Health Study (1995-1997; 1194 men and 7842 women) and a follow-up conducted in 2001 (697 men and 2751 women). Symptomatology was ascertained using the Hospital Anxiety and Depression Scale and BMD was measured at the forearm using single-energy X-ray absorptiometry. Information on medication use and lifestyle was self-reported, and these, together with anthropometric measures were tested in multivariate analyses.
  
  
  RESULTS
  In men, adjusted BMD was 2.6% lower at the ultradistal forearm for those with depressive symptoms and 2.6% lower at the ultradistal and 2.0% lower at the distal forearm for those with anxiety symptoms. In women, adjusted BMD at the distal and ultradistal forearm was lower for heavier women with depressive symptoms but this relationship diminished with decreasing weight. Forearm BMD was similar for women with or without anxiety symptoms. Longitudinally, neither depressive nor anxiety symptoms were associated with bone loss over 4.6 years.
  
  
  CONCLUSIONS
  Findings cannot be generalised to other skeletal sites and a longer follow-up period may be necessary to detect differences in bone loss.
  
  
  CONCLUSIONS
  These results indicate that depressive and anxiety symptoms are cross-sectionally associated with reduced BMD. These findings provide further evidence to support monitoring BMD in individuals diagnosed with psychiatric illness.
authors.affiliation: University of Melbourne, Department of Clinical and Biomedical Sciences: Barwon Health, Geelong, Australia. lanaw@barwonhealth.org.au
authors.forename: Lana J
authors.initials: LJ
authors.lastname: Williams
authors.forename: Ottar
authors.initials: O
authors.lastname: Bjerkeset
authors.forename: Arnulf
authors.initials: A
authors.lastname: Langhammer
authors.forename: Michael
authors.initials: M
authors.lastname: Berk
authors.forename: Julie A
authors.initials: JA
authors.lastname: Pasco
authors.forename: Margaret J
authors.initials: MJ
authors.lastname: Henry
authors.forename: Berit
authors.initials: B
authors.lastname: Schei
authors.forename: Siri
authors.initials: S
authors.lastname: Forsmo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000150:complications / Q000503:physiopathology*; D015519:Bone Density; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009664:Norway / Q000453:epidemiology; D010024:Osteoporosis / Q000209:etiology / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D012737:Sex Factors; D018709:Statistics, Nonparametric; D055815:Young Adult