title: Quantitative Heel Ultrasound (QUS) measures of bone quality in association with mood and anxiety disorders.
abstract: BACKGROUND
  The common mental disorders are potential risk factors for low bone mass as a result of disease and/or medication-related processes. Quantitative heel ultrasound (QUS) is a portable and relatively cheap screening tool for determining fracture risk. Thus, we investigated the association between QUS parameters, mood and anxiety disorders in a population-based sample of 745 men and 897 women.
  
  
  METHODS
  Using a clinical interview (SCID-I/NP), mood and anxiety disorders were identified. Bone quality was established using QUS and included the following parameters: Broadband Ultrasound Attenuation (BUA), Speed of Sound (SOS) and Stiffness Index (SI). Anthropometry, socio-economic status (SES), medication use and lifestyle factors were determined.
  
  
  RESULTS
  In men, mood and anxiety disorders were associated with lower age-weight- and smoking-adjusted SOS, BUA and SI. In women, age was an effect modifier. Among younger women (≤ 40yr), mood disorders were associated with lower age-weight- and smoking-adjusted SOS and SI but not BUA. No differences were detected in older women or women with anxiety disorders. These patterns persisted after adjustment for activity, alcohol, calcium intake, SES and medications.
  
  
  CONCLUSIONS
  Cross-sectional study design, and possible residual or unrecognised confounding.
  
  
  CONCLUSIONS
  Our data suggest that bone quality, as measured by QUS, is reduced among men and younger women with a history of mood disorders. Furthermore, an inverse association between anxiety disorders and bone quality was evident for men. Thus, QUS may be a useful screening tool for determining fracture risk within these populations.
authors.affiliation: School of Medicine, Deakin University, Geelong, Australia. lanaw@barwonhealth.org.au
authors.forename: Lana J
authors.initials: LJ
authors.lastname: Williams
authors.forename: Julie A
authors.initials: JA
authors.lastname: Pasco
authors.forename: Felice N
authors.initials: FN
authors.lastname: Jacka
authors.forename: Jason M
authors.initials: JM
authors.lastname: Hodge
authors.forename: Mark A
authors.initials: MA
authors.lastname: Kotowicz
authors.forename: Michael
authors.initials: M
authors.lastname: Berk
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000453:epidemiology / Q000503:physiopathology*; D015519:Bone Density / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D050723:Fractures, Bone; D006365:Heel / Q000000981:diagnostic imaging* / Q000502:physiology*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology / Q000503:physiopathology*; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D017678:Sex Distribution; D014463:Ultrasonography; D055815:Young Adult