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Increased Risk of Osteoporosis in Patients With Depression

A Population-Based Retrospective Cohort Study



      To investigate the relationship between depression and risk of subsequent osteoporosis development.

      Participants and Methods

      A population-based retrospective cohort analysis was conducted using the Longitudinal Health Insurance Database 2000 of Taiwan. We included 32,978 patients in the depression cohort and 131,912 patients in the no-depression cohort between January 1, 1998, and December 31, 2008, and calculated the incidence rates of newly diagnosed osteoporosis. We used Cox proportional hazards models to assess the effects of depression. The Kaplan-Meier method was applied to estimate the cumulative osteoporosis incidence curves.


      Patients with depression were 1.30 times more likely to experience osteoporosis than those without depression. The risk was higher for patients with severe depression and mild depression than for those without depression. A greater hazard ratio magnitude was observed in patients aged 35 to 49 years. We also observed a significant decrease in osteoporosis risk in patients with depression treated with antidepressant agents.


      The incidence of osteoporosis in Taiwan is associated with an a priori depression history. The risk was identified in both men and women, particularly in patients aged 35 to 49 years, and was inversely correlated with antidepressant drug treatment.

      Abbreviations and Acronyms:

      BMD (bone mineral density), CKD (chronic kidney disease), COPD (chronic obstructive pulmonary disease), CRH (corticotropin-releasing hormone), HR (hazard ratio), ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification), IRR (incidence rate ratio), LHID2000 (Longitudinal Health Insurance Database 2000), NHI (National Health Insurance), NHIRD (National Health Insurance Research Database), SSRI (selective serotonin reuptake inhibitor)
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