Bone Health in Mood Disorders: A Narrative Review about Clinical and Biological Connections

Antonella Maria Pia De Novellis, Giulia Ferrazzi, G. Galeazzi, M. Marchi, Matteo Meloni, L. Pingani, Silvia Ferrari
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Abstract

Evidence about bone health in people affected by psychiatric disorders is limited. This narrative review aims to highlight what is known, up to the present time, about clinical connections between bone health and psychiatric disorders, particularly depressive disorders (DD) and bipolar disorders (BD), in terms of common biological pathways. Besides inflammation, we focused on two molecules of growing interest: neuropeptide Y (NPY) and the neuro-hormone melatonin. Also, the role of psychoactive drugs on bone tissue was explored. For the preparation of this narrative review, the scientific literature of the most recent 7 years from PubMed, Springer Nature, Science Direct (Elsevier), Wiley Online, ResearchGate, and Google Scholar databases was analyzed. Reviewed evidence reveals that people diagnosed with BD or DD have an increased risk of both fractures and osteoporosis; NPY reduces bone loss induced by longer periods of depression and “buffers” psychological stress effects on bone health. MLT shows beneficial effects in osteoporosis and bone healing. Lithium, a mood stabilizer, shows potential bone-protective activity, while antipsychotic and antidepressant treatments may increase the risk of bone tissue damage, though further investigation is needed.
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情绪失调症患者的骨骼健康:关于临床与生物学联系的叙述性综述
有关精神障碍患者骨骼健康的证据非常有限。这篇叙述性综述旨在从共同的生物通路角度,强调目前已知的有关骨骼健康与精神障碍,尤其是抑郁障碍(DD)和双相情感障碍(BD)之间的临床联系。除了炎症之外,我们还重点研究了两种日益受到关注的分子:神经肽 Y(NPY)和神经激素褪黑激素。此外,我们还探讨了精神药物对骨组织的作用。为了编写这篇叙述性综述,我们分析了 PubMed、Springer Nature、Science Direct (Elsevier)、Wiley Online、ResearchGate 和 Google Scholar 数据库中最近 7 年的科学文献。综述证据显示,被诊断患有 BD 或 DD 的人骨折和骨质疏松症的风险都会增加;NPY 可减少因长期抑郁而导致的骨质流失,并 "缓冲 "心理压力对骨骼健康的影响。MLT 对骨质疏松症和骨愈合有好处。锂是一种情绪稳定剂,具有潜在的骨骼保护作用,而抗精神病和抗抑郁治疗可能会增加骨组织损伤的风险,但仍需进一步研究。
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