Carlone Cristiano, Rusconi Anna Carlotta, Valeriani Giuseppe, Todini Liliana, Coccanari de' Fornari Maria Antonietta, Biondi Massimo
Dipartimento di Neurologia e Psichiatria, Sapienza Università di Roma.
Riv Psichiatr. 2015 Jul-Aug;50(4):161-7. doi: 10.1708/2002.21642.
Osteoporosis and depression are two chronic diseases that affect large population groups with great impact on morbidity, mortality and quality of life. Existing studies of the relationship between depression and osteoporosis have been heterogeneous in their design and use of diagnostic instruments for depression, which might have contributed to the different results on the comorbidity of these two conditions. Moreover, the direction of the causative link is still controversial and the etiology remains unclear. Definitely, limited data suggest that osteoporosis may enhance depressive symptoms, while far more studies have shown that depression adversely affects bone density and increases fracture risk. Thus the correlation of these diseases is still under research. This review comments on a plausible causative relationship and underlying mechanisms that might elucidate the link between two very common diseases. We describe the possible impact of osteoporosis on moods and the effect of depression on bone health. In particular, we focus on the role of the hypothalamic-pituitary-adrenocortical and sympathoadrenal axes, of the parathyroid hormone and cytokines. We also describe the effect of the antidepressant drugs as well as lifestyles that may explain this effect.
骨质疏松症和抑郁症是两种影响大量人群的慢性疾病，对发病率、死亡率和生活质量有重大影响。现有的关于抑郁症与骨质疏松症之间关系的研究在设计以及抑郁症诊断工具的使用方面存在异质性，这可能导致了这两种疾病合并存在时出现不同的结果。此外，因果关系的方向仍存在争议，病因也尚不清楚。当然，有限的数据表明骨质疏松症可能会加重抑郁症状，而更多的研究表明抑郁症会对骨密度产生不利影响并增加骨折风险。因此，这些疾病之间的相关性仍在研究中。本综述对一种可能的因果关系及潜在机制进行了评论，这些机制可能会阐明这两种非常常见疾病之间的联系。我们描述了骨质疏松症对情绪的可能影响以及抑郁症对骨骼健康的影响。特别地，我们关注下丘脑 - 垂体 - 肾上腺皮质轴和交感 - 肾上腺轴、甲状旁腺激素和细胞因子的作用。我们还描述了抗抑郁药物以及可能解释这种影响的生活方式的作用。
