Major depressive disorder and bone mass in adolescents and young adults.
Depression has been associated with reduced bone mass in adults, but the mechanisms remain unclear. In addition, little is known about the association between depression and bone health during growth and development. To address this knowledge gap, we examined bone density and structure in 222 adolescents and young adults (69% females, mean ± SD age: 19.0 ± 1.5 years), enrolled within 1 month of starting a selective serotonin reuptake inhibitor (SSRI) or unmedicated. Psychiatric functioning was assessed with self-report and researcher-administered instruments, including the Longitudinal Interval Follow-up Evaluation for Adolescents (A-LIFE). Anthropometric and laboratory measures included dual-energy x-ray absorptiometry and peripheral quantitative computed tomography scans. Linear multivariable regression analysis tested the association between depression and bone mass, after accounting for relevant confounders. The presence of current depression was associated with a significant reduction in age-sex-height-race-specific bone mineral density (BMD) and content (BMC) of total body less head and lumbar spine. The findings varied by assessment method with self-report scales, capturing symptom severity over the prior week or two, yielding the weakest associations. Depression was also associated with reduced cortical thickness and a trend for increased endosteal circumference. In contrast, generalized anxiety disorder was not associated with bone deficits. In sum, depressive illness is associated with significantly lower bone mass in youths. Future investigations must examine whether bone recovery is possible following depression remission or whether remedial interventions are warranted to optimize bone mass in order to minimize the long-term risk of osteoporosis.
Department of Psychiatry, The University of Iowa, Iowa City, IA, USA; Department of Pediatrics, The University of Iowa, Iowa City, IA, USA.
Chadi A
CA
Calarge
Brandon D
BD
Butcher
Trudy L
TL
Burns
William H
WH
Coryell
Janet A
JA
Schlechte
Babette S
BS
Zemel
D015502:Absorptiometry, Photon; D000293:Adolescent; D015519:Bone Density; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003710:Demography; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D016896:Treatment Outcome; D055815:Young Adult
BONE QCT/microCT; BONE-BRAIN-NERVOUS SYSTEM INTERACTIONS; DXA