Bipolar disorder and bone health: A case-control study

Lana J Williams; Amanda L Stuart; Michael Berk; Sharon L Brennan-Olsen; Jason M Hodge; Shae E Quirk; Heli Koivumaa-Honkanen; Risto Honkanen; Jeremi Heikkinen; Vinoomika Chandrasekaran; Jasmine R Cleminson; Julie A Pasco

doi:10.1016/j.jad.2022.04.016

Bipolar disorder and bone health: A case-control study

J Affect Disord. 2022 Jul 1:308:39-43. doi: 10.1016/j.jad.2022.04.016. Epub 2022 Apr 6.

Affiliations

¹ Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, Geelong, Victoria, Australia; Barwon Health, Geelong, Victoria, Australia. Electronic address: l.williams@deakin.edu.au.
² Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, Geelong, Victoria, Australia.
³ Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, Geelong, Victoria, Australia; Barwon Health, Geelong, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia; Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Parkville, Victoria, Australia.
⁴ Deakin University, Institute for Health Transformation, Geelong, Victoria, Australia; Deakin University, School of Health and Social Development, Geelong, Victoria, Australia; The University of Melbourne, Department of Medicine-Western Health, St Albans, Victoria, Australia; University of Melbourne and Western Health, Australian Institute for Musculoskeletal Science, St Albans, Victoria, Australia.
⁵ Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, Geelong, Victoria, Australia; Barwon Health, Geelong, Victoria, Australia; Geelong Centre for Emerging Infectious Diseases, Geelong, Victoria, Australia.
⁶ Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, Geelong, Victoria, Australia; University of Eastern Finland, Institute of Clinical Medicine, Kuopio, Finland; University of Eastern Finland, Kuopio Musculoskeletal Research Unit (KMRU), Kuopio, Finland.
⁷ University of Eastern Finland, Institute of Clinical Medicine, Kuopio, Finland; University of Eastern Finland, Kuopio Musculoskeletal Research Unit (KMRU), Kuopio, Finland; Mental Health and Wellbeing Center, Kuopio University Hospital, Kuopio, Finland.
⁸ University of Eastern Finland, Institute of Clinical Medicine, Kuopio, Finland; University of Eastern Finland, Kuopio Musculoskeletal Research Unit (KMRU), Kuopio, Finland.
⁹ Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, Geelong, Victoria, Australia; Barwon Health, Geelong, Victoria, Australia; The University of Melbourne, Department of Medicine-Western Health, St Albans, Victoria, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.

PMID: 35398110
DOI: 10.1016/j.jad.2022.04.016

Abstract

Background: Bipolar disorder (BD) is associated with significant psychological and physical comorbidity. Yet little is known about the bone health of individuals with BD. Thus, we aimed to investigate the association between BD and bone health in a population-based sample of women.

Methods: Women with a history of BD (cases; n = 117) were recruited from public and private health care settings and controls, without BD, were drawn from the Geelong Osteoporosis Study (n = 909). BD was identified using a semi-structured clinical interview (SCID-I/NP). Bone mineral density (BMD) was measured at the spine, femoral neck and total body using dual energy x-ray absorptiometry, and bone quality by quantitative heel ultrasound and included the following parameters: Speed of Sound (SOS), Broadband Ultrasound Attenuation (BUA) and Stiffness Index (SI). Weight and height were measured and information on medication use and lifestyle was obtained.

Results: Adjusted mean BMD among the cases was 4.3% lower at the hip and 1.6% lower at the total body compared to controls. Age was an effect modifier at the spine. Among women <50 years, mean spine BMD for cases was 3.5% lower than controls. No differences in spine BMD for those ≥50 years were detected. Cases also had a 1.0%, 3.2% and 7.8% lower adjusted mean SOS, BUA and SI compared to controls, respectively.

Limitations: Course, chronicity and recovery of BD were not explored in relation to bone health.

Conclusion: These data suggest BD is associated with low bone quantity and quality in women. Replication and research into underlying mechanisms is warranted.

Keywords: Bipolar disorder; Bone density; Bone quality; Comorbidity; Depression; Mania; Neuroscience; Psychiatry.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Absorptiometry, Photon
Bipolar Disorder* / diagnostic imaging
Bone Density
Case-Control Studies
Female
Humans
Osteoporosis* / diagnostic imaging
Osteoporosis* / epidemiology
Ultrasonography