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Major Depressive Disorder and Bone Mass in Adolescents and Young Adults
Author(s) -
Calarge Chadi A,
Butcher Brandon D,
Burns Trudy L,
Coryell William H,
Schlechte Janet A,
Zemel Babette S
Publication year - 2014
Publication title -
journal of bone and mineral research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.882
H-Index - 241
eISSN - 1523-4681
pISSN - 0884-0431
DOI - 10.1002/jbmr.2249
Subject(s) - medicine , bone mass , major depressive disorder , young adult , psychology , clinical psychology , gerontology , osteoporosis , mood
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. © 2014 American Society for Bone and Mineral Research.