A woman who suffers from depression is more likely to reach the menopause with a higher risk of bone fractures (osteoporosis), compared to a woman who does not have depression. In a study published inArchives of Internal Medicine it was found that 17% of women with depression had less bone mass in a section of their hip, called the femoral neck, compared to 2% of women who did not have depression.

Low bone mass in the lumbar spine was found in 20% of depressed women, compared to 9% of non-depressed women. An X-ray technique called DXA scanning was used to measure bone mass.

The researchers, from the NIMH (National Institute of Mental Health) explained that women with depression have immune systems which are overactive. Their bodies overproduce a chemical that leads to bone loss – this chemical, known as IL-6, also promotes inflammation.

The study involved 133 women, 89 depressed and 44 non-depressed. They were aged 21-45. All the women had the same risk factors, with the exception of depression. They had similar intakes of calcium, caffeine, alcohol – their use of tobacco was also similar, as were their levels of physical fitness, use of oral contraceptives, and their age of first menstrual period.

The scientists found that the hip bones of depressed women were especially susceptible to thinning – these bones fracture more frequently among older people with osteoporosis. The lower bone mass puts the patient at higher risk of costly, and sometimes fatal fractures.

NIMH Deputy Director Richard Nakamura, PhD, said “Osteoporosis is a silent disease. Too often, the first symptom a clinician sees is when a patient shows up with a broken bone. Now we know that depression can serve as a red flag – that depressed women are more likely than other women to approach menopause already at higher risk of fractures.”

During our youth bone mass reaches its peak – after that it continues slowly thinning for the rest of our lives, thinning at a faster rate after a woman’s menopause, the researchers explained. The authors stressed that the factor linking premenopausal osteoporosis risk in their study was definitely depression.

There was no association between the severity of depression and the amount of bone mass loss.

The immune-system imbalance experienced by some depressed women may be linked to excessive adrenalin, the researchers say. It is well know that depressed people produce more adrenalin – adrenalin can over-stimulate the immune system.

“Low Bone Mass in Premenopausal Women With Depression”
Farideh Eskandari, MD, MHSc; Pedro E. Martinez, MD; Sara Torvik, MSN; Terry M. Phillips, PhD; Esther M. Sternberg, MD; Sejal Mistry, BS; Donna Ronsaville, PhD; Robert Wesley, PhD; Caitlin Toomey, BS; Nancy G. Sebring, MEd; James C. Reynolds, MD; Marc R. Blackman, MD; Karim A. Calis, PharmD; Philip W. Gold, MD; Giovanni Cizza, MD, PhD, MHSc; for the Premenopausal, Osteoporosis Women, Alendronate, Depression (POWER) Study Group
Arch Intern Med. 2007;167(21):2329-2336.
Click here to view abstract online

Written by – Christian Nordqvist