 |
|
|
 |
Prevalence of Depressive Symptoms in Postmenopausal Women with Low Bone Mineral Density and/or Prevalent Vertebral Fracture:
Results from the Multiple Outcomes of Raloxifene Evaluation (MORE) Study
STUART L. SILVERMAN, WEI SHEN, MICHAEL E. MINSHALL, SUNNY XIE, and KATHRYN H. MOSES ABSTRACT. Objective. To examine the prevalence of depressive symptoms in a cross-sectional study of postmenopausal women with osteoporosis with and without prevalent vertebral fracture. Methods. Participants were a subset of English-speaking women (n = 3798, mean age 66.7 yrs) from the Multiple Outcomes of Raloxifene Evaluation trial, who had low bone mineral density (BMD) and/or prevalent vertebral fractures. Vertebral fractures were measured at baseline by radiography using a semiquantitative technique. Depressive symptoms were assessed at baseline using the Geriatric Depression Scale (GDS), a valid and reliable scale for depression screening in elderly patients. Women were considered as probably depressed if ≥ 6 symptoms of depression were reported. Results. Postmenopausal women with prevalent vertebral fracture reported more depressive symptoms as assessed by the GDS than women without prevalent vertebral fracture (1.54 vs 1.26; p = 0.001). There was an absolute increase of 2.5% (p = 0.008) in the prevalence of probable depression (GDS score ≥ 6) in women with prevalent fracture compared to those without prevalent fracture. The prevalence of probable depression was 4.1% among women without prevalent vertebral fracture and 6.6% in women with a prevalent vertebral fracture. The prevalence of probable depression was 3-fold higher in women with at least 3 prevalent vertebral fractures compared to women without prevalent fracture (12.8% vs 4.1%; p < 0.001). Conclusion. Postmenopausal women with prevalent vertebral fractures had greater prevalence of depressive symptoms and probable depression as assessed by the GDS than women without vertebral fracture with low BMD. The dual diagnosis of depression and osteoporosis may mean worse health outcomes. Patients with prevalent vertebral fractures may be considered not only for interventions that address fracture risk reduction, but also for psychosocial interventions that address depressive symptoms. (J Rheumatol 2007;34:140–4) Key Indexing Terms:
VERTEBRAL FRACTURE From Cedars Sinai Medical Center, UCLA, Greater Los Angeles Veterans Administration Health System, Los Angeles, California; Eli Lilly and Company, Indianapolis, Indiana; Center for Outcomes Research, Fishers, Indiana; Indiana University School of Medicine, Department of Public Health, Indianapolis, Indiana; and Forest Laboratories, Inc., New York, New York, USA. S.L. Silverman, MD, Cedars Sinai Medical Center, UCLA, Greater Los Angeles Veterans Administration Health System; W. Shen, PhD, Eli Lilly and Company; M.E. Minshall, MPH, Center for Outcomes Research; S. Xie, MS, Forest Laboratories, Inc.; K.H. Moses, MPH, Indiana University School of Medicine. Address reprint requests to Dr. S.L. Silverman, The OMC Clinical Research Center, 8641 Wilshire Boulevard, Suite 310, Beverly Hills, CA 90211. E-mail: stuarts@OMCresearch.org Accepted for publication September 26, 2006. |
