Bone quality reduced in mood disorder patients

Nov 1 2012

By Mark Cowen, Senior medwireNews Reporter

Results from an Australian study show that men and young women with mood disorders have significantly lower bone quality than their mentally healthy counterparts.

The team also found a significant association between anxiety disorders and reduced bone quality in men, but not women.

"This study… provides valuable information regarding bone structure, rather than bone mineral density only, in the context of mood and anxiety disorders, which could improve estimation of fracture risk and aid in treatment decisions," comment Lana Williams (Deakin University, Geelong) and co-authors.

The researchers used quantitative heel ultrasound (QUS) to assess bone quality in 745 men and 897 women from the Geelong Osteoporosis Study. QUS parameters included; speed of sound (SOS), broadband ultrasound attenuation (BUA), and stiffness index (SI).

Overall, 17.0% of men met criteria for a lifetime mood disorder, such as depression, bipolar disorder, or dysthymia, and 7.1% met criteria for a lifetime anxiety disorder, such as panic disorder, obsessive-compulsive disorder, or generalised anxiety disorder. Respective rates for these disorders in women were 28% and 12.6%.

After adjustment for age, weight, and smoking status, the researchers found that men with mood disorders had significantly reduced SOS (1559.9 vs 1568.3 m/sec) and SI [94.5 vs 98.7%) compared with mentally healthy men. The pattern was similar for BUA (117.1 vs 119.5 dB/MHz), but the association was not significant.

These associations persisted after further adjustment for height, physical activity, alcohol and calcium intake, socio-economic status, and use of medications known to positively or negatively affect bone health.

In women, the association between mood disorders and reduced bone quality was only evident among those aged less than 40 years. Indeed among this age group, those with mood disorders had significantly lower adjusted mean SOS (1580.6 vs 1593.3 m/sec) and SI [100.5 vs 105.5%), but not BUA, compared with mentally healthy women.

The presence of anxiety disorders was also associated with significantly lower adjusted mean SOS, BUA, and SI in men. However, no such associations were found in women.

Williams and team conclude in the Journal of Affective Disorders: "Our data suggest that bone quality, as measured by QUS, is reduced among men and younger women with a lifetime history of mood disorders. Furthermore, an inverse association between a lifetime history of anxiety disorders and bone quality was also evident for men."

They add: "QUS is a portable, safe, non-invasive and inexpensive way to assess bone quality. Thus, QUS may be a useful screening tool for determining fracture risk and changes in bone over time within these populations."

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