Skip to main content
SpringerLink
Log in

Depression risk in female patients with osteoporosis in primary care practices in Germany

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Summary

Thirty-five thousand four hundred eighty-three female osteoporosis patients were compared with 35,483 patients without osteoporosis regarding the incidence of depression. The risk of depression is significantly increased for patients with osteoporosis compared with patients without osteoporosis in primary care practices within Germany.

Introduction

The objectives of the present study were to analyze the incidence of depression in German female patients with osteoporosis and to evaluate the risk factors for depression diagnosis within this patient population.

Methods

This study was a retrospective database analysis conducted in Germany utilizing the Disease Analyzer® Database (IMS Health, Germany). The study population included 70,966 patients between 40 and 80 years of age from 1072 primary care practices. The observation period was between 2004 and 2013. Follow-up duration was 5 years and was completed in April 2015. A total of 35,483 osteoporosis patients were selected after applying exclusion criteria, and 35,483 controls were chosen and then matched (1:1) to osteoporosis patients based on age, sex, health insurance coverage, depression diagnosis in the past, and follow-up duration after index date. The analyses of depression-free survival were carried out using Kaplan-Meier curves and log-rank tests. Cox proportional hazards models (dependent variable: depression) were used to adjust for confounders.

Results

Depression diagnoses were presented in 33.0 % of the osteoporosis group and 22.7 % of the control group after the 5-year follow-up (p < 0.001). Dementia, cancer, heart failure, coronary heart disease, and diabetes were associated with a higher risk of developing depression (p < 0.001). Private health insurance was associated with a lower risk of depression. There was no significant effect of fractures on depression risk.

Conclusion

The risk of depression is significantly increased for patients with osteoporosis in primary care practices within Germany.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Bartl R, Bartl C, Mutschler W (2003) Diagnostik und Therapie der Osteoporose Strategie für eine effiziente Prävention von Folgefrakturen. Unfallchirurg 106:526–541

    Article  CAS  PubMed  Google Scholar 

  2. DVO e.V (2010) Osteoporose-Leitlinie Patientenversion

  3. Murray CJL, Lopez AD, eds (1996) The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020. Geneva, World Health Organization

  4. Svedbom A, Hernlund E, Ivergård M, Compston J, Cooper C, Stenmark J, McCloskey EV, Jönsson B, Kanis JA (2013) Osteoporosis in the European Union: a compendium of country-specific reports. Arch Osteoporos 8:137

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Garnero P, Sornay-Rendu E, Chapuy MC, Delmas PD (1996) Increased bone turnover in late postmenopausal women is a major determinant of osteoporosis. J Bone Miner Res 11:337–349

    Article  CAS  PubMed  Google Scholar 

  6. Lindner R, Klein S, Hadji P, Gothe H, Verheyen F, Häussler B: Bone Evaluation Study (BEST): Epidemiologie der Osteoporose in Deutschland sowie Analysen zur Inanspruchnahme von Diagnostik und Therapie. GMDS 2012. 57. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e.V

  7. Robert Koch-Institut (Hrsg) (2014) Osteoporose. Faktenblatt zu GEDA 2012: Ergebnisse der Studie »Gesundheit in Deutschland aktuell 2012«. RKI, Berlin

  8. OECD.stat: Historical population data and projections (1950–2050). stats.oecd.org/Index.aspx? DataSetCode = POP_PROJ#. Last Accessed on 9 Feb 2015

  9. Konnopka A, Jerusel N, Konig HH (2009) The health and economic consequences of osteopenia- and osteoporosis-attributable hip fractures in Germany: estimation for 2002 and projection until 2050. Osteoporos Int 20:1117–29

    Article  CAS  PubMed  Google Scholar 

  10. Wayne JK (2011) Epidemiology and treatment of depression in patients with chronic medical illness. Dialogues Clin Neurosci 13(1):7–23

    Google Scholar 

  11. Becher H, Kostev K, Schröder-Bernhardi D (2009) Validity and representativeness of the “Disease Analyzer” patient database for use in pharmacoepidemiological and pharmacoeconomic studies. Int J Clin Pharmacol Ther 47:617–626

    Article  CAS  PubMed  Google Scholar 

  12. Lossnitzer N, Herzog W, Störk S, Wild B, Müller-Tasch T (2013) Incidence rates and predictors of major and minor depression in patients with heart failure. Int J Cardiol 167:502–507

    Article  PubMed  Google Scholar 

  13. Maske U, Busch M, Jacobi F, Riedel-Helle S, Scheidt-Nave C, Hapke U (2013) Chronische somatische Erkrankungen und Beeinträchtigung der psychischen Gesundheit bei Erwachsenen in Deutschland: Ergebnisse der bevölkerungsrepräsentativen Querschnittsstudie Gesundheit in Deutschland aktuell (GEDA). Psychiatr Prax 40(4):207–213

    Article  PubMed  Google Scholar 

  14. Pieper L, Schulz H, Klotsche J, Eichler T, Wittchen HU (2008) Depression als komorbide Störung in der primärärztlichen Versorgung. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 51:411–421

    Article  CAS  Google Scholar 

  15. Snowden MB, Atkins DC, Steinman LE et al (2015) Longitudinal association of dementia and depression. Am J Geriatr Psychiatry 2(9):897–905

    Article  Google Scholar 

  16. Neumann NU, Frasch K (2008) Neue Aspekte zur Lauftherapie bei Demenz und Depression – klinische und neurowissenschaftliche Grundlagen. Deutsche Zeitschrift für Sportmedizin 59(2)

  17. Massie MJ (2002) The prevalence of depression in patients with cancer. NIH State-of-the-Science Conference on Symptom Management in Cancer: Pain, Depression, and Fatigue

  18. Lichtman JH, Bigger TJ, Blumenthal JA, Frasure-Smith N, Kaufmann PG et al (2008) Depression and coronary heart disease. Circulation 118:1768–1775

    Article  PubMed  Google Scholar 

  19. Anda R, Williamson D, Jones D et al (1993) Depressed affect, hopelessness, and the risk of ischemic heart disease in a cohort of US adults. Epidemiology 4:285–294

    Article  CAS  PubMed  Google Scholar 

  20. Frasure-Smith N, Lespérance F (2006) Recent evidence linking coronary heart disease and depression. Can J Psychiatry 51(12):730–737

    Article  PubMed  Google Scholar 

  21. Katon WJ (2008) The comorbidity of diabetes mellitus and depression. Am J Med 121(11 Suppl 2):8–15

    Article  Google Scholar 

  22. Burcusa SL, Iacono WG (2007) Risk for recurrence in depression. Clin Psychol Rev 27(8):959–985

    Article  PubMed  PubMed Central  Google Scholar 

  23. Belsher G, Costello CG (1988) Relapse after recovery from unipolar depression: a critical review. Psychol Bull 104(1):84–96

    Article  CAS  PubMed  Google Scholar 

  24. Breyer F (1984) Moral Hazard und der optimale Krankenversicherungsvertrag. Eine Übersicht. Zeitschrift Ges Staatswissenschaft 140:288–307

    Google Scholar 

  25. Härter M, Baumeister H, Reuter K et al (2007) Increased 12-month prevalence rates of mental disorders in patients with chronic somatic disease. Psychther Psychosom 76:354–360

    Article  Google Scholar 

  26. Bermejo I, Klars G, Bohm K et al (2009) Evaluation des nationalen Gesundheitsziels Depressive Erkrankungen: verhindern, früh erkennen, nachhaltig behandeln. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 52:897–904

    Article  CAS  Google Scholar 

  27. Gerlach FM, Beyer M, Muth C, Saal K, Gensichen J (2006) New perspectives in the primary care of the chronically ill—against the “tyranny of the urgent”. Part 1: chronic diseases as a challenge for primary care). Z Arztl Fortbild Qualitatssich 100(5):335–343

    PubMed  Google Scholar 

  28. Gerlach FM, Beyer M, Saal K, Peitz M, Gensichen J (2006) New perspectives in the primary care of the chronically ill—against the “tyranny of the urgent”. Part 2: the chronic care model und case management as the basis of a forward-looking approach to primary care). Z Arztl Fortbild Qualitatssich 100(5):345–352

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Fresenius University of Applied Sciences, Idstein, Germany

    J. Drosselmeyer

  2. Department of Social and Preventive Medicine, University of Potsdam, Potsdam, Germany

    M. A. Rapp

  3. Department of Bone Oncology, Endocrinology and Reproductive Medicine, Nordwest Hospital, Frankfurt am Main, Germany

    P. Hadji

  4. Epidemiology, IMS Health GmbH & Co. OHG, Darmstädter Landstraße 108, 60598, Frankfurt am Main, Germany

    K. Kostev

Authors
  1. J. Drosselmeyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. A. Rapp
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P. Hadji
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. K. Kostev
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to K. Kostev.

Ethics declarations

Conflicts of interest

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Drosselmeyer, J., Rapp, M.A., Hadji, P. et al. Depression risk in female patients with osteoporosis in primary care practices in Germany. Osteoporos Int 27, 2739–2744 (2016). https://doi.org/10.1007/s00198-016-3584-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-016-3584-9

Keywords

Search

Navigation