title: Insecure attachment style predicts low bone mineral density in postmenopausal women. A pilot study.
abstract: Major depressive disorder (MDD) and osteoporosis are two common disorders with high morbidity and mortality rates. Conflicting data have found associations between MDD and low bone mineral density (BMD) or osteoporosis, although causative factors are still unclear. A pilot study was designed with the aim to assess the relationship between MDD and BMD in postmenopausal women with MDD compared to healthy volunteers. We hypothesized that attachment style (AS) mediated this relationship.
  
  
  
  The sample was made of 101 postmenopausal women, 49 with MDD and 52 age-matched healthy volunteers. Structured clinical interview and Beck Depression Inventory (BDI) were performed to assesse MDD. AS was evaluated using the Relationship Questionnaire (RQ). BMD was measured by dual energy X-ray absorptiometry.
  
  
  
  The univariate analysis showed that women with MDD had lower BMD values as compared to healthy volunteers. In the regression models MDD diagnosis and BDI score were not significant predictors of low BMD. The “preoccupied” pattern of insecure AS was a significant, independent predictor of decreased BMD in all skeletal sites: lumbar spine (p=0.008), femoral neck (p=0.011), total hip (p=0.002).
  
  
  
  This is the first study exploring the relationship between AS, MDD and BMD. Our results support the link between MDD and low BMD. We found that insecure AS was a risk factor for decreased BMD, regardless of depression. Insecure AS may play a role in the relationship between MDD and BMD or may constitute a risk factor itself. Therapeutic interventions focused on AS could improve psychiatric disorders and physical diseases related to low BMD.
authors.affiliation: Chair of Psychiatry, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy - Psychiatric Clinic, Fondazione Policlinico "Tor Vergata", Rome, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Niolu
authors.affiliation: Chair of Psychiatry, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Bianciardi
authors.affiliation: Chair of Psychiatry, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Di Lorenzo
authors.affiliation: Chair of Psychiatry, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Nicolai
authors.affiliation: Section of Ginecology and Obstetrics, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Celi
authors.affiliation: Chair of Psychiatry, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Ribolsi
authors.affiliation: Section of Ginecology and Obstetrics, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.
authors.forename: Adalgisa
authors.initials: A
authors.lastname: Pietropolli
authors.affiliation: Section of Ginecology and Obstetrics, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Ticconi
authors.affiliation: Chair of Orthopaedics and Traumatology, Department of Surgery, University of Rome "Tor Vergata", Rome, Italy - Orthopaedic Clinic, Fondazione Policlinico "Tor Vergata", Rome, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Tarantino
authors.affiliation: Chair of Psychiatry, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy - Psychiatric Clinic, Fondazione Policlinico "Tor Vergata", Rome, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Siracusano
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D015519:Bone Density; D003865:Major Depressive Disorder / Q000150:complications / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D007406:Interview, Psychological; D008875:Middle Aged; D009769:Object Attachment; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000503:physiopathology / Q000523:psychology*; D010045:Outpatients / Q000523:psychology; D010555:Personality Inventory; D010865:Pilot Projects; D017698:Postmenopause / Q000502:physiology / Q000523:psychology*; D012307:Risk Factors; D012944:Social Support; D011795:Surveys and Questionnaires