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COMMENTS & OPINIONS
A Possible Role of Recurrent Major Depression in Risk of Fracture
Sinead M. O’Brien, MB, MRCPsych
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Richards and colleagues1 concluded that daily use of SSRIs in adults 50 years and older remained associated with a 2-fold increased risk of clinical fragility fracture after adjustment for potential confounders. The authors stated that a potential weakness of this study was the lack of evaluation of the subjects by a psychiatrist and that, instead, symptoms of depression were evaluated by using the Mental Component Scale and the mental health inventory 5 scales of the medical outcomes study.
However severity of depressive symptoms were not assessed nor were the number of previous depressive episodes recorded. Current or history of major depression is associated with decreased bone mineral density at all trabecular sites, with a 10% to 14% decrease found at the hip,2 which increases the risk of hip fracture by more than 40% over a 10-year period.3 Therefore, a recurrent depressive disorder could predispose to . . . [Full Text of this Article]
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RELATED LETTER
A Possible Role of Recurrent Major Depression in Risk of Fracture—Reply
J. Brent Richards, Alexandra Papaioannou, Jonathan D. Adachi, Lawrence Joseph, Heather E. Whitson, Jerilynn C. Prior, David Goltzman, and for the CaMos Research Group
Arch Intern Med. 2007;167(21):2370-2371.
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RELATED ARTICLE
Effect of Selective Serotonin Reuptake Inhibitors on the Risk of Fracture
J. Brent Richards, Alexandra Papaioannou, Jonathan D. Adachi, Lawrence Joseph, Heather E. Whitson, Jerilynn C. Prior, David Goltzman, and for the Canadian Multicentre Osteoporosis Study (CaMos) Research Group
Arch Intern Med. 2007;167(2):188-194.
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