Niolu Cinzia, Bianciardi Emanuela, Di Lorenzo Giorgio, Nicolai Sara, Celi Monica, Ribolsi Michele, Pietropolli Adalgisa, Ticconi Carlo, Tarantino Umberto, Siracusano Alberto
Chair of Psychiatry, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy - Psychiatric Clinic, Fondazione Policlinico "Tor Vergata", Rome, Italy.
Chair of Psychiatry, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
Riv Psichiatr. 2016 Jul-Aug;51(4):143-148. doi: 10.1708/2342.25118.
Major depressive disorder (MDD) and osteoporosis are two common disorders with high morbidity and mortality rates. Conflicting data have found associations between MDD and low bone mineral density (BMD) or osteoporosis, although causative factors are still unclear. A pilot study was designed with the aim to assess the relationship between MDD and BMD in postmenopausal women with MDD compared to healthy volunteers. We hypothesized that attachment style (AS) mediated this relationship.
The sample was made of 101 postmenopausal women, 49 with MDD and 52 age-matched healthy volunteers. Structured clinical interview and Beck Depression Inventory (BDI) were performed to assesse MDD. AS was evaluated using the Relationship Questionnaire (RQ). BMD was measured by dual energy X-ray absorptiometry.
The univariate analysis showed that women with MDD had lower BMD values as compared to healthy volunteers. In the regression models MDD diagnosis and BDI score were not significant predictors of low BMD. The “preoccupied” pattern of insecure AS was a significant, independent predictor of decreased BMD in all skeletal sites: lumbar spine (p=0.008), femoral neck (p=0.011), total hip (p=0.002).
This is the first study exploring the relationship between AS, MDD and BMD. Our results support the link between MDD and low BMD. We found that insecure AS was a risk factor for decreased BMD, regardless of depression. Insecure AS may play a role in the relationship between MDD and BMD or may constitute a risk factor itself. Therapeutic interventions focused on AS could improve psychiatric disorders and physical diseases related to low BMD.
重度抑郁症（MDD）和骨质疏松症是两种发病率和死亡率都很高的常见疾病。尽管致病因素仍不明确，但相互矛盾的数据已发现MDD与低骨矿物质密度（BMD）或骨质疏松症之间存在关联。本研究旨在评估绝经后患有MDD的女性与健康志愿者相比，MDD与BMD之间的关系。我们假设依恋风格（AS）介导了这种关系。
样本由101名绝经后女性组成，其中49名患有MDD，52名年龄匹配的健康志愿者。采用结构化临床访谈和贝克抑郁量表（BDI）评估MDD。使用关系问卷（RQ）评估AS。通过双能X线吸收法测量BMD。
单因素分析显示，与健康志愿者相比，患有MDD的女性BMD值较低。在回归模型中，MDD诊断和BDI评分不是低BMD的显著预测因素。不安全AS的“过度关注”模式是所有骨骼部位BMD降低的显著独立预测因素：腰椎（p = 0.008）、股骨颈（p = 0.011）、全髋（p = 0.002）。
这是第一项探索AS、MDD和BMD之间关系的研究。我们的结果支持MDD与低BMD之间的联系。我们发现，不安全AS是BMD降低的一个危险因素，与抑郁无关。不安全AS可能在MDD与BMD之间的关系中起作用，或者本身可能构成一个危险因素。针对AS的治疗干预可能会改善与低BMD相关的精神疾病和身体疾病。
