Decreased lumbar bone mineral density in patients with major depression

Schweiger, U.; Deuschle, Michael; Kørner, Alex; Schmider, Jürgen; Gotthardt, U.; Heuser, Isabella

doi:10.1016/0006-3223(94)91072-3

Cited by 47 publications

(64 citation statements)

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“…These findings suggest that intra-abdominal GRs may maintain their sensitivity to glucocorticoids, while other tissues/cell types are resistant. In support of this possibility, studies also have shown decreased bone mineral density in depressed patients, 65,66 since elevated glucocorticoids have also been associated with bone loss.…”

Section: Figure 2 -Model Of Glucocorticoid Receptor (Gr) Activationmentioning

confidence: 89%

O eixo hipotálamo-pituitária-adrenal, a função dos receptores de glicocorticóides e sua importância na depressão

Juruena

Cleare

Pariante

2004

Rev. Bras. Psiquiatr.

143

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Objective: Changes in the hypothalamic-pituitary-adrenocortical (HPA) system are characteristic of depression. Because the effects of glucocorticoids are mediated by intracellular receptors including, most notably, the glucocorticoid receptor (GR), several studies have examined the number and/or function of GRs in depressed patients. Methods: Review scientific evidences have consistently demonstrated that GR function is impaired in major depression, resulting in reduced GR IntroductionHormones play a critical role in the development and expression of a wide range of behaviours. One aspect of the influence of hormones on behaviour is their potential contribution to the pathophysiology of psychiatric disorders and the mechanism of action of psychotropic drugs, particularly in major depression. Of all endocrine axes, the hypothalamic-pituitary-adrenal (HPA) axis has been the most widely evaluated. 1,2 The HPA axis plays a fundamental role in the response to external and internal stimuli including psychological stressors. Abnormalities in the function of the HPA axis have been described in people experiencing psychiatric disorders. Moreover, is well known the fundamental role of stress in precipitating episodes of psychiatric disorders in predisposed individuals. 1 These abnormalities seem related to changes in the ability of circulating glucocorticoids to exert their negative feedback on the secretion of HPA hormones through binding to the mineralocorticoid receptor (MR) and the glucocorticoid receptor (GR) in HPA tissues. 2,3,6 In fact, previous studies have described both an impaired HPA negative feedback, leading to hypercortisolemia, as in melancholic depression. 2,6 In addition to melancholic depression, a spectrum of other conditions may be associated with increased and prolonged activation of the HPA axis, including anorexia nervosa with or without malnutrition, obsessive-compulsive disorder, panic anxiety, chronic active alcoholism, alcohol and narcotic withdrawal, excessive exercising, poorly controlled diabetes mellitus, childhood sexual abuse and hyperthyroidism. 7 Another group of states is characterized by hypoactivation of the stress system, rather than sustained activation, in which chronically reduced secretion of CRH may result in pathological hypoarousal and an enhanced HPA negative feedback. Patients with post-traumatic stress disorder, atypical, seasonal depression and the chronic fatigue syndrome fall in this category (see Table 1). Similarly, patients with fibromyalgia have decreased urinary free

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Section: Figure 2 -Model Of Glucocorticoid Receptor (Gr) Activationmentioning

confidence: 89%

O eixo hipotálamo-pituitária-adrenal, a função dos receptores de glicocorticóides e sua importância na depressão

Juruena

Cleare

Pariante

2004

Rev. Bras. Psiquiatr.

143

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“…They measured BMD by single-energy quantitative computerized tomography (SE-QCT) in 70 depressed outpatients (53 women) and 88 controls (58 women). They found that the depressed group had BMD values, on average, 15% lower than the control group, after adjusting for age [6]. The majority of analyses have replicated the original 1994 finding of Schweiger et al lower BMD among persons with depression or depressive symptoms relative to comparison groups [7][8][9][10][11][12][13][14][15][16][17][18].…”

Section: Depression Depressive Symptoms and Osteoporosismentioning

confidence: 92%

Depression and osteoporosis: epidemiology and potential mediating pathways

2007

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Introduction-There have been numerous studies examining the association between depression and bone mineral density (BMD), but the underlying nature of this relationship remains unclear. Independent of this association, there is a growing body of evidence that depression impacts the risk for fracture in older adults. This article reviews the current epidemiological evidence regarding comorbidity of depression, low bone mineral density, and fracture.

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“…Depression is not only a powerful impediment to psychological well-being, but evidence is accumulating that it is an important risk factor for physical disease as well (Penninx et al, 1999;Stoltz et al, 1999). For instance, an increasing number of studies have shown that depression is a predictor of all-cause mortality, and also of more specific health problems, such as cardiovascular disease, (auto-)immune disorders, low bone mineral density and potentially even cancer (Zonderman et al, 1989;Schweiger et al, 1994; Leonard and Miller, 1995;Glassman and Shapiro, 1998;Musselman et al, 1998;Penninx et al, 1998;Pop et al, 1998). Given these associations, the issue of depression has become progressively more important in epidemiological studies on predictors of physical health outcomes (Glassman and Shapiro, 1998;Musselman et al, 1998;Nyklíček et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Multiple assessments of depressive symptoms as an index of depression in population-based samples

Nyklı́ček

Scherders

Pop

2004

Psychiatry Research

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General rightsCopyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.-Users may download and print one copy of any publication from the public portal for the purpose of private study or research -You may not further distribute the material or use it for any profit-making activity or commercial gain -You may freely distribute the URL identifying the publication in the public portal Take down policy If you believe that this document breaches copyright, please contact us providing details, and we will remove access to the work immediately and investigate your claim. AbstractThe incremental validity of repeated measurements of a short depression questionnaire was examined regarding the clinical diagnosis of depression. Participants were 951 randomly selected women of around menopausal age. They completed the Edinburgh Depression Scale (EDS) at two time points, with approximately 18 months in between. At the second time point, they participated in a structured clinical interview for depression diagnosis based on the Research Diagnostic Criteria (RDC). With repeated assessments, specificity and negative predictive value (NPV) did not change much relative to a single assessment, with a specificity of 95.0% and a NPV of 91.7% at a cut-off score of 12 on the EDS. As expected, sensitivity dropped, from 87.9% to 58.8%. However, positive predictive value (PPV) increased from 42.0% to 49.1% at a cut-off of 12. When using a cutoff score of 15 on the EDS, the PPV based on both EDS measurements reached 61.8%, yielding a 25-fold probability of being a case for women scoring above 15 at both time points (OR = 24.54, 95% CI = 14.24 -42.28). In conclusion, the 10-item EDS is a reliable, valid and valuable screening instrument. When employed repeatedly, a more stable depression may be tapped, which can be of substantial value for both epidemiological research and clinical practice.

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Decreased lumbar bone mineral density in patients with major depression

Cited by 47 publications

References 0 publications

O eixo hipotálamo-pituitária-adrenal, a função dos receptores de glicocorticóides e sua importância na depressão

O eixo hipotálamo-pituitária-adrenal, a função dos receptores de glicocorticóides e sua importância na depressão

Depression and osteoporosis: epidemiology and potential mediating pathways

Multiple assessments of depressive symptoms as an index of depression in population-based samples

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