Bone Mineral Density in Women with Depression
Open accessAbstract
BACKGROUND: Depression is associated with alterations in behavior and neuroendocrine systems that are risk factors for decreased bone mineral density. This study was undertaken to determine whether women with past or current major depression have demonstrable decreases in bone density. METHODS: We measured bone mineral density at the hip, spine, and radius in 24 women with past or current major depression and 24 normal women matched for age, body-mass index, menopausal status, and race, using dual-energy x-ray absorptiometry. We also evaluated cortisol and growth hormone secretion, bone metabolism, and vitamin D-receptor alleles. RESULTS: As compared with the normal women, the mean (+/-SD) bone density in the women with past or current depression was 6.5 percent lower at the spine (1.00+/-0.15 vs. 1.07+/-0.09 g per square centimeter, P=0.02), 13.6 percent lower at the femoral neck (0.76+/-0.11 vs. 0.88+/-0.11 g per square centimeter, P<0.001), 13.6 percent lower at Ward's triangle (0.70+/-0.14 vs. 0.81+/-0.13 g per square centimeter, P<0.001), and 10.8 percent lower at the trochanter (0.66+/-0.11 vs. 0.74+/-0.08 g per square centimeter, P<0.001). In addition, women with past or current depression had higher urinary cortisol excretion (71+/-29 vs. 51+/-19 micrograms per day [196+/-80 vs. 141+/-52 nmol per day], P=0.006), lower serum osteocalcin concentration (P=0.04), and lower urinary excretion of deoxypyridinoline (P=0.02). CONCLUSIONS: Past or current depression in women is associated with decreased bone mineral density.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Although the association between depression and loss of bone mineral density has been reported inconsistently, most studies have found low bone mineral density in patients with depressive symptoms or major depressive disorder.
“Although the association between depression and loss of BMD has been reported inconsistently, most studies have found low BMD in patients with depressive symptoms or major depressive disorder (477-483).”
From Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care (2011) · cites this paper as [477]
Cites
Lifetime Prevalence of Specific Psychiatric Disorders in Three Sites
Robins, L. N. (1984) · Archives of General Psychiatry · doi:10.1001/archpsyc.1984.01790210031005 · Cited by 2,550 · see citing works
Prediction of bone density from vitamin D receptor alleles
Morrison, N. A., Qi, J. C., Tokita, A., Kelly, P. J., Crofts, L. A., Nguyen, T. V., Sambrook, P. N., & Eisman, J. A. (1994) · Nature · doi:10.1038/367284a0 · Cited by 1,916 · see citing works
Gold, P. W., Loriaux, D. L., Roy, A., Kling, M. A., Calabrese, J. R., Kellner, C. H., Nieman, L. K., Post, R. M., Pickar, D., Gallucci, W. T., et al. (1986) · New England Journal of Medicine · doi:10.1056/nejm198605223142101 · Cited by 766 · see citing works
Self-citationClinical and Biochemical Manifestations of Depression
Gold, P. W., Goodwin, F. K., & Chrousos, G. P. (1988) · New England Journal of Medicine · doi:10.1056/nejm198808113190606 · Cited by 547 · see citing works
Self-citationBrady, L. S., Whitfield, H. J., Fox, R. J., Gold, P. W., & Herkenham, M. A. (1991) · Journal of Clinical Investigation · doi:10.1172/jci115086 · Cited by 338 · see citing works
Self-citationBone mineral density in relation to polymorphism at the vitamin D receptor gene locus.
Hustmyer, F. G., Peacock, M., Hui, S., et al. (1994) · Journal of Clinical Investigation · doi:10.1172/jci117568 · Cited by 265 · see citing works
Brady, L. S., Gold, P. W., Herkenham, M. A., Lynn, A. B., & Whitfield, H. J. (1992) · Brain Research · doi:10.1016/0006-8993(92)90459-m · Cited by 236 · see citing works
Self-citationMelton, L. J., Kan, S. H., Wahner, H. W., & Riggs, B. L. (1988) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(88)90036-4 · Cited by 227 · see citing works
Zelissen, P. M. J., CROUGHS, R. J. M., van Rijk, P. P., & Raymakers, J. A. (1994) · Annals of Internal Medicine · doi:10.7326/0003-4819-120-3-199402010-00005 · Cited by 220 · see citing works
Decreased Bone Mineral Density in Medicated Psychiatric Patients
Halbreich, U. M., Rojansky, N., Palter, S. F., Hreshchyshyn, M. M., Kreeger, J., Bakhai, Y., & Rosan, R. C. (1995) · Psychosomatic Medicine · doi:10.1097/00006842-199509000-00011 · Cited by 193 · see citing works
Outcome of bone mineral density in anorexia nervosa patients 11.7 years after first admission
Herzog, W., Minne, H. W., Deter, H., Leidig, G., Schellberg, D., Wüster, C. C., Gronwald, R. G., Sarembe, E., Kröger, F., Bergmann, G., et al. (1993) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.5650080511 · Cited by 191 · see citing works
Bone density of the radius, spine, and proximal femur in osteoporosis
Mazess, R. B., Barden, H. S., Ettinger, M. P., et al. (1988) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.5650030104 · Cited by 185 · see citing works
Spector, T. D., Keen, R. W., Arden, N., Morrison, N. A., Major, P. J., Nguyen, T. V., Kelly, P. J., Baker, J. R., Sambrook, P. N., Lanchbury, J. S., et al. (1995) · BMJ · doi:10.1136/bmj.310.6991.1357 · Cited by 184 · see citing works
Bone mineral density and bone turnover before and after surgical cure of Cushing's syndrome.
Hermus, A., Smals, A., Swinkels, L., Huysmans, D., Pieters, G., Sweep, C., Corstens, F., & Kloppenborg, P. (1995) · Journal of Clinical Endocrinology and Metabolism · doi:10.1210/jcem.80.10.7559865 · Cited by 181 · see citing works
Low lumbar bone mineral density in patients with major depression
(1994) · American Journal of Psychiatry · doi:10.1176/ajp.151.11.1691 · Cited by 165 · see citing works
Sex differences in peak adult bone mineral density
Kelly, P. J., Twomey, L. T., Sambrook, P. N., & Eisman, J. A. (1990) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.5650051112 · Cited by 151 · see citing works
Normal bone mineral density following cure of Cushing's syndrome
Manning, P. J., Evans, M. C., & Reid, I. R. (1992) · Clinical Endocrinology · doi:10.1111/j.1365-2265.1992.tb01437.x · Cited by 143 · see citing works
Loss of bone in the proximal part of the femur following unstable fractures of the leg.
van der Wiel, H. E., Lips, P. T. A. M., Nauta, J. J. P., Patka, P., Haarman, H. J. T. M., & Teule, G. J. J. (1994) · Journal of Bone and Joint Surgery · doi:10.2106/00004623-199402000-00009 · Cited by 79 · see citing works
Vitamin-D-receptor-gene polymorphism and bone loss
Keen, R. W., Major, P. J., Lanchbury, J. S., et al. (1995) · The Lancet · doi:10.1016/s0140-6736(95)90740-8 · Cited by 75 · see citing works
COMPARING THE MARGINAL TOTALS OF SQUARE CONTINGENCY TABLES
Fleiss, J. L., & Everitt, B. J. (1971) · British Journal of Mathematical and Statistical Psychology · doi:10.1111/j.2044-8317.1971.tb00454.x · Cited by 74 · see citing works
Contributions of exercise, body composition, and age to bone mineral density in premenopausal women
Alekel, L. D., Clasey, J. L., Fehling, P. C., et al. (1995) · Medicine & Science in Sports & Exercise · doi:10.1249/00005768-199511000-00003 · Cited by 50 · see citing works
Bone mass and subtle abnormalities in ovulatory function in healthy women
Waller, K., Reim, J., Fenster, L., Swan, S. H., Brumback, B., Windham, G. C., Lasley, B. L., Ettinger, B. B., & Marcus, R. (1996) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.81.2.663 · Cited by 48 · see citing works
Drug-Induced Disorders of Bone Metabolism
Jones, G., & Sambrook, P. N. (1994) · Drug Safety · doi:10.2165/00002018-199410060-00006 · Cited by 42 · see citing works
Osteoporosis and schizophrenia: Can we limit known risk factors?
Abraham, G., Friedman, R. H., Verghese, C., & de Leon, J. (1995) · Biological Psychiatry · doi:10.1016/0006-3223(95)00062-l · Cited by 40 · see citing works
Nielsen, H. K., Brixen, K., Kassem, M. S., Charles, P., & Mosekilde, L. (1992) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.74.6.1592888 · Cited by 35 · see citing works
Skeletal recovery after treatment of Cushing's: still room for improvement
Kleerekopper, M. (1995) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.80.10.2856 · Cited by 6 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Protective and Damaging Effects of Stress Mediators
McEwen, B. S. (1998) · New England Journal of Medicine · doi:10.1056/nejm199801153380307 · Cited by 6,733 · see citing works
DE HERT, M., CORRELL, C. U., BOBES, J., CETKOVICH‐BAKMAS, M., COHEN, D., ASAI, I., DETRAUX, J., GAUTAM, S., MÖLLER, H., NDETEI, D. M., et al. (2011) · World Psychiatry · doi:10.1002/j.2051-5545.2011.tb00014.x · Cited by 2,488 · see citing works
Alexopoulos, G. S. (2005) · The Lancet · doi:10.1016/s0140-6736(05)66665-2 · Cited by 2,024 · see citing works
Endocrinology of the stress response
Charmandari, E., Tsigos, C., & Chrousos, G. (2005) · Annual Review of Physiology · doi:10.1146/annurev.physiol.67.040403.120816 · Cited by 1,799 · see citing works
Self-citationGold, P. W., & Chrousos, G. P. (2002) · Molecular Psychiatry · doi:10.1038/sj.mp.4001032 · Cited by 1,274 · see citing works
Self-citationEmotions, morbidity, and mortality: new perspectives from psychoneuroimmunology.
Kiecolt-Glaser, J. K., McGuire, L., Robles, T. F., & Glaser, R. (2002) · Annual Review of Psychology · doi:10.1146/annurev.psych.53.100901.135217 · Cited by 1,176 · see citing works
The cellular neurobiology of depression
Manji, H. K., Drevets, W. C., & Charney, D. S. (2001) · Nature Medicine · doi:10.1038/87865 · Cited by 1,182 · see citing works
Glucocorticoid receptors in major depression: relevance to pathophysiology and treatment
Pariante, C. M., & Miller, A. H. (2001) · Biological Psychiatry · doi:10.1016/s0006-3223(00)01088-x · Cited by 1,147 · see citing works
Mood disorders and allostatic load
McEwen, B. S. (2003) · Biological Psychiatry · doi:10.1016/s0006-3223(03)00177-x · Cited by 1,135 · see citing works
Sex, stress and the hippocampus: allostasis, allostatic load and the aging process
MCEWEN, B. (2002) · Neurobiology of Aging · doi:10.1016/s0197-4580(02)00027-1 · Cited by 753 · see citing works
The organization of the stress system and its dysregulation in depressive illness
Gold, P. W. (2015) · Molecular Psychiatry · doi:10.1038/mp.2014.163 · Cited by 654 · see citing works
Self-citationResearch and treatment approaches to depression
Wong, M.-L., & Licinio, J. (2001) · Nature Reviews Neuroscience · doi:10.1038/35072566 · Cited by 656 · see citing works
Lenze, E. J., Rogers, J. C., Martire, L. M., Mulsant, B. H., Rollman, B. L., Dew, M. A., Schulz, R., & Reynolds, C. F. (2001) · The American Journal of Geriatric Psychiatry · doi:10.1097/00019442-200105000-00004 · Cited by 593 · see citing works
Association of depression with medical illness: Does cortisol play a role?
Brown, E. S., Varghese, F. P., & McEwen, B. S. (2004) · Biological Psychiatry · doi:10.1016/s0006-3223(03)00473-6 · Cited by 578 · see citing works
Socio‐economic differentials in peripheral biology: Cumulative allostatic load
Seeman, T., Epel, E., Gruenewald, T., Karlamangla, A., & McEwen, B. S. (2010) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.2009.05341.x · Cited by 579 · see citing works
Allostatic load as a predictor of functional decline
Karlamangla, A. S., Singer, B. H., McEwen, B. S., Rowe, J. W., & Seeman, T. E. (2002) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(02)00399-2 · Cited by 483 · see citing works
Schulkin, J., W. Gold, P., & S. McEwen, B. (1998) · Psychoneuroendocrinology · doi:10.1016/s0306-4530(97)00099-1 · Cited by 423 · see citing works
Glutamate and Depression: Clinical and Preclinical Studies
PAUL, I. A., & SKOLNICK, P. (2003) · Annals of the New York Academy of Sciences · doi:10.1196/annals.1300.016 · Cited by 408 · see citing works
Licinio, J., & Wong, M.-L. (1999) · Molecular Psychiatry · doi:10.1038/sj.mp.4000586 · Cited by 380 · see citing works
Alesci, S., Martinez, P. E., Kelkar, S., Ilias, I., Ronsaville, D. S., Listwak, S. J., Ayala, A. R., Licinio, J., Gold, H. K., Kling, M. A., et al. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2004-1667 · Cited by 372 · see citing works
Self-citationDiem, S. J. (2007) · Archives of Internal Medicine · doi:10.1001/archinte.167.12.1240 · Cited by 326 · see citing works
Lamers, S. M. A., Bolier, L., Westerhof, G. J., Smit, F., & Bohlmeijer, E. T. (2012) · Journal of Behavioral Medicine · doi:10.1007/s10865-011-9379-8 · Cited by 306 · see citing works
“For example, depression is associated with increased osteoporosis (Michelson et al., 1996), coronary heart disease (Glassman & Shapiro, 1998), diabetes complications (De Groot et al., 2001), cancer incidence, progression (Spiegel & Giese-Davis, 2003) and cancer mortality (Satin et al., 2009), and…”
BackgroundAssociation of Low Bone Mineral Density With Selective Serotonin Reuptake Inhibitor Use by Older Men
Haney, E. M. (2007) · Archives of Internal Medicine · doi:10.1001/archinte.167.12.1246 · Cited by 286 · see citing works
Factors associated with the lumbar spine and proximal femur bone mineral density in older men
Cauley, J. A., Fullman, R. L., Stone, K. L., Zmuda, J. M., Bauer, D. C., Barrett-Connor, E., Ensrud, K., Lau, E. M. C., Orwoll, E. S., & For the Mr. OS Research Group (2005) · Osteoporosis International · doi:10.1007/s00198-005-1866-8 · Cited by 258 · see citing works
Clinical and Biochemical Manifestations of Depression: Relation to the Neurobiology of Stress
Gold, P. W., Machado-Vieira, R., & Pavlatou, M. G. (2015) · Neural Plasticity · doi:10.1155/2015/581976 · Cited by 259 · see citing works
Vitamin D and the occurrence of depression: causal association or circumstantial evidence?
Bertone-Johnson, E. R. (2009) · Nutrition Reviews · doi:10.1111/j.1753-4887.2009.00220.x · Cited by 240 · see citing works
Regulation of bone remodeling by the central and peripheral nervous system
Elefteriou, F. (2008) · Archives of Biochemistry and Biophysics · doi:10.1016/j.abb.2008.03.016 · Cited by 229 · see citing works
New insights into the role of cortisol and the glucocorticoid receptor in severe depression
Gold, P. W., Drevets, W. C., Charney, D. S., & Drevets, W. C. (2002) · Biological Psychiatry · doi:10.1016/s0006-3223(02)01480-4 · Cited by 219 · see citing works
Self-citationRamasubbu, R., Taylor, V. H., Samaan, Z., Sockalingham, S., Li, M., Patten, S., Rodin, G., Schaffer, A., Beaulieu, S., & McIntyre, R. S. (2012) · Annals of Clinical Psychiatry · doi:10.1177/104012371202400110 · Cited by 206 · see citing works
Bone mineral density in subjects using central nervous system-active medications
Kinjo, M., Setoguchi, S., Schneeweiss, S., & Solomon, D. H. (2005) · The American Journal of Medicine · doi:10.1016/j.amjmed.2005.07.033 · Cited by 191 · see citing works
Sex differences in mood disorders: Perspectives from humans and rodent models
Seney, M. L., & Sibille, E. (2014) · Biology of Sex Differences · doi:10.1186/s13293-014-0017-3 · Cited by 181 · see citing works
The Association of Bone Mineral Density and Depression in an Older Population
Robbins, J., Hirsch, C., Whitmer, R., Cauley, J., Harris, T., & Study, F. T. C. H. (2001) · Journal of the American Geriatrics Society · doi:10.1046/j.1532-5415.2001.49149.x · Cited by 180 · see citing works
Fracture Risk From Psychotropic Medications: A Population-Based Analysis
Bolton, J. M., Metge, C., Lix, L., Prior, H., Sareen, J., & Leslie, W. D. (2008) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e31817d5943 · Cited by 158 · see citing works
Low Bone Mass in Premenopausal Women With Depression
Eskandari, F. (2007) · Archives of Internal Medicine · doi:10.1001/archinte.167.21.2329 · Cited by 157 · see citing works
Depression and osteoporosis: epidemiology and potential mediating pathways
Mezuk, B., Eaton, W. W., & Golden, S. H. (2008) · Osteoporosis International · doi:10.1007/s00198-007-0449-2 · Cited by 134 · see citing works
Williams, L. J., Henry, M. J., Berk, M., Dodd, S., Jacka, F. N., Kotowicz, M. A., Nicholson, G. C., & Pasco, J. A. (2008) · International Clinical Psychopharmacology · doi:10.1097/yic.0b013e3282f2b3bb · Cited by 117 · see citing works
Schweiger, U., Weber, B., Deuschle, M., & Heuser, I. (2000) · American Journal of Psychiatry · doi:10.1176/ajp.157.1.118 · Cited by 101 · see citing works
Depression and low bone mineral density: a meta-analysis of epidemiologic studies
Wu, Q., Magnus, J. H., Liu, J., Bencaz, A. F., & Hentz, J. G. (2009) · Osteoporosis International · doi:10.1007/s00198-009-0918-x · Cited by 102 · see citing works
Bone mineral density in premenopausal women with major depressive disorder
Yazıcı, K. M., Akıncı, A., Sütçü, A., & Özçakar, L. (2003) · Psychiatry Research · doi:10.1016/s0165-1781(03)00017-9 · Cited by 84 · see citing works
FITZGERALD, P., O'BRIEN, S. M., SCULLY, P., RIJKERS, K., SCOTT, L. V., & DINAN, T. G. (2006) · Psychological Medicine · doi:10.1017/s003329170500632x · Cited by 66 · see citing works
Bone density and depressive disorder: a meta‐analysis
Schweiger, J. U., Schweiger, U., Hüppe, M., Kahl, K. G., Greggersen, W., & Fassbinder, E. (2016) · Brain and Behavior · doi:10.1002/brb3.489 · Cited by 60 · see citing works
McEwen, B. S. (2004) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2004.6.2/bmcewen · Cited by 54 · see citing works
Sleep Characteristics and Daytime Cortisol Levels in Older Adults
Morgan, E., Schumm, L. P., McClintock, M., Waite, L., & Lauderdale, D. S. (2017) · Sleep · doi:10.1093/sleep/zsx043 · Cited by 52 · see citing works
Endocrine factors in key structural and intracellular changes in depression
Gold, P. W. (2021) · Trends in Endocrinology & Metabolism · doi:10.1016/j.tem.2021.01.003 · Cited by 35 · see citing works
Self-citationKahl, K. G., Rudolf, S., Dibbelt, L., Stoeckelhuber, B. M., Gehl, H.-B., Hohagen, F., & Schweiger, U. (2005) · Osteoporosis International · doi:10.1007/s00198-004-1711-5 · Cited by 27 · see citing works
Bone mineral density in young women on methadone substitution
Milos, G., Gallo, L. M., Sosic, B., Uebelhart, D., Goerres, G., Haeuselmann, H.-J., & Eich, D. (2011) · Calcified Tissue International · doi:10.1007/s00223-011-9510-4 · Cited by 18 · see citing works
Lee, S. H., Mastronardi, C. A., Li, R. W., Paz-Filho, G., Dutcher, E. G., Lewis, M. D., Vincent, A. D., Smith, P. N., Bornstein, S. R., Licinio, J., et al. (2019) · Translational Psychiatry · doi:10.1038/s41398-018-0351-z · Cited by 12 · see citing works
- Authors
- Michelson, D., Stratakis, C., Hill, L., Reynolds, J., Galliven, E., Chrousos, G., & Gold, P.
- Affiliations
- National Institute of Mental Health (US)
- National Institutes of Health (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1996-10-17
- Volume
- 335
- Issue
- 16
- Pages
- 1176-1181
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2317060418
- Cited by
- 471
- References
- 26
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 13 · 2023: 4 · 2022: 8 · 2021: 6 · 2020: 5 · 2019: 7 · 2018: 8 · 2017: 9 · 2016: 13 · 2015: 13 · 2014: 15 · 2013: 15 · 2012: 21
- FWCI
- 23.82
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Keywords
- depression, bone mineral density, osteoporosis, women, hip bone density, spine bone density, urinary cortisol, osteocalcin, deoxypyridinoline, bone metabolism, VDR polymorphisms, growth hormone
- MeSH terms
- Adult, Bone and Bones, Depressive Disorder, Female, Hip Joint, Humans, Hydrocortisone, Insulin-Like Growth Factor I, Middle Aged, Radius, Reference Values, Spine, Absorptiometry, Photon, Bone Density, Case-Control Studies
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
