Depression as a risk factor for fracture in women: a 10 year longitudinal study

Williams, Lana J., Pasco, Julie A., Jackson, Henry, Kiropoulos, Litza, Stuart, Amanda L., Jacka, Felice N. and Berk, Michael 2016, Depression as a risk factor for fracture in women: a 10 year longitudinal study, Journal of affective disorders, vol. 192, pp. 34-40, doi: 10.1016/j.jad.2015.11.048.

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Title Depression as a risk factor for fracture in women: a 10 year longitudinal study
Author(s) Williams, Lana J.ORCID iD for Williams, Lana J.
Pasco, Julie A.ORCID iD for Pasco, Julie A.
Jackson, Henry
Kiropoulos, Litza
Stuart, Amanda L.ORCID iD for Stuart, Amanda L.
Jacka, Felice N.ORCID iD for Jacka, Felice N.
Berk, MichaelORCID iD for Berk, Michael
Journal name Journal of affective disorders
Volume number 192
Start page 34
End page 40
Total pages 7
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2016-03-01
ISSN 1573-2517
Keyword(s) Bone
Bone mineral density
Science & Technology
Life Sciences & Biomedicine
Clinical Neurology
Neurosciences & Neurology
Summary BACKGROUND: Previous research has demonstrated deficits in bone mineral density (BMD) among individuals with depression. While reduced BMD is a known risk for fracture, a direct link between depression and fracture risk is yet to be confirmed. METHODS: A population-based sample of women participating in the Geelong Osteoporosis Study was studied using both nested case-control and retrospective cohort study designs. A lifetime history of depression was identified using a semi-structured clinical interview (SCID-I/NP). Incident fractures were identified from radiological reports and BMD was measured at the femoral neck using dual energy absorptiometry. Anthropometry was measured and information on medication use and lifestyle factors was obtained via questionnaire. RESULTS: Among 179 cases with incident fracture and 914 controls, depression was associated with increased odds of fracture (adjusted odds ratio (OR) 1.57, 95%CI 1.04-2.38); further adjustment for psychotropic medication use appeared to attenuate this association (adjusted OR 1.52, 95%CI 0.98-2.36). Among 165 women with a history of depression at baseline and 693 who had no history of depression, depression was associated with a 68% increased risk of incident fracture (adjusted hazard ratio (HR) 1.68, 95%CI 1.02-2.76), with further adjustment for psychotropic medication use also appearing to attenuate this association (adjusted HR 1.58, 95%CI 0.95-2.61). LIMITATIONS: Potential limitations include recall bias, unrecognised confounding and generalizability. CONCLUSIONS: This study provides both cross-sectional and longitudinal evidence to suggest that clinical depression is a risk factor for radiologically-confirmed incident fracture, independent of a number of known risk factors. If there is indeed a clinically meaningful co-morbidity between mental and bone health, potentially worsened by psychotropic medications, the issue of screening at-risk populations needs to become a priority.
Language eng
DOI 10.1016/j.jad.2015.11.048
Field of Research 110399 Clinical Sciences not elsewhere classified
110319 Psychiatry (incl Psychotherapy)
11 Medical And Health Sciences
17 Psychology And Cognitive Sciences
Socio Economic Objective 920116 Skeletal System and Disorders (incl. Arthritis)
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, Elsevier
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Document type: Journal Article
Collections: Faculty of Health
School of Medicine
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