Depression Following Fracture in Adults: A Comparative Study between Men and Women at a Tertiary Care Centre

  • Dr Sudheendra PR Assistant Professor, Department of Orthopedics, Shimoga Institute of Medical Sciences, Shimoga, Rajiv Gandhi University of Health Sciences, Karnataka, Rajiv Gandhi University of Health Sciences, Karnataka, India
  • Dr Ramprasad KS Associate Professor, Department of Psychiatry, Shimoga Institute of Medical Sciences, Shimoga, India
  • Dr Manjunath Rajashekharaiah Junior Resident, Department of Psychiatry, Shimoga Institute of Medical Sciences, Shimoga, Rajiv Gandhi University of Health Sciences, Karnataka, India
Keywords: Hip fracture, Vertebral fractures, Long bone fractures, Depression

Abstract

Introduction: Fractures are usually associated with functional impairment and dependence; also bears psychological effect as the quality of life decreases. Many studies have shown the presence of depression associated with the fracture and hence the study was done to know the same in our institution.

Methods: Inclusion criteria: Adults aged more than 35 years of both sexes who had sustained fractures of long bones, hip and vertebral fractures who were admitted as inpatients earlier, and requiring prolonged rehabilitation.

Exclusion criteria: Severely medically ill patients. The mood state was evaluated in patients with fractures after taking consent with Beck’s Depression inventory. Follow up of inpatient with fracture were done after their discharge.

Results: This study shows that among patients with fractures, higher prevalence of moderate and severe depression is in females. Post-menopausal women are most severely affected.

Conclusion: Postmenopausal females suffer more from depression associated with fractures than males.

Downloads

Download data is not yet available.

References

1. Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ. Global Burden of Disease and Risk Factors. Washington: The World Bank; 2006.

2. Beekman AT, Deeg DJ, van Tilburg T, Smit JH, Hooijer C, van Tilburg W. Major and minor depression in later life: a study of prevalence and risk factors. J Affect Disord. 1995;36(1-2):65-75. [PubMed]

3. Reddy VM, Chandrashekar CR. Prevalence of mental and behavioural disorders in India : a meta-analysis. Indian J Psychiatry. 1998;40(2):149-57. [PubMed]

4. Voshaar RC, Banerjee S, Horan M, Baldwin R, Pendleton N, Proctor R, et al. Predictor of incident depression after hip fracture surgery. Am J Geriatr Psychiatry. 2007;15(9):807-14. [PubMed]

5. Lauritzen JB: Hip fractures: incidence, risk factors, energy absorption, and prevention. Bone. 1996;18(1):S65–S75. [PubMed]

6. Whooley MA, Kip KE, Cauley JA, Ensrud KE, Nevitt MC, Browner WS. Depression, Falls, and Risk if Fracture in Older Women. Arch Intern Med. 1999;159(5):484-90.

7. Deuschle M, Schweiger U, Weber B, Gotthardt U, Korner A, Schmider J, et al. Diurnal activity and pulsatility of the hypothalamus-pituitary-adrenal system in male depressed patients and healthy controls. J Clin Endocrinol Metab. 1997;82(1):234–38.

8. Lesch KP, Laux G, Schulte HM, Pfuller H, Beckmann H. Corticotropin and cortisol response to human CRH as a probe for HPA system integrity in major depressive disorder. Psychiatry Res. 1988;24(1):25–34.

9. Peeters GM, van Schoor NM, van Rossum EF, Visser M, Lips P. The relationship between cortisol, muscle mass and muscle strength in older persons and the role of genetic variations in the glucocorticoid receptor. Clin Endocrinol. 2008; 69(4):673–82. [PubMed]

10. Peeters GM, van Schoor NM, Visser M, Knol DL, Eekhoff EM, de Ronde W, et al. Relationship between cortisol and physical performance in older persons. Clin Endocrinol. 2007;67(3):398–406. [PubMed]

11. Dubin NH, Monahan LK, Yu-Yahiro JA, Michael RH, Zimmerman SI, Hawkes W, et al. Serum concentrations of steroids, parathyroid hormone, and calcitonin in postmenopausal women during the year following hip fracture: effect of location of fracture and age. J Gerontol A Biol Sci Med Sci. 1999;54(9):M467–73. [PubMed]

12. Butcher SK, Killampalli V, Chahal H, Kaya Alpar E, Lord JM. Effect of age on susceptibility to post-traumatic infection in the elderly. Biochem Soc Trans. 2003;31(2):449–51. [PubMed]

13. Michelson D, Stratakis C, Hill L. Bone mineral density in women with depression. N Engl J Med. 1996;335:1176–81. [PubMed]

14. Schweiger U, Deuschle M, Korner A. Low lumbar bone mineral density in patients with major depression. Am J Psychiatr. 1994;151:1691–95. [PubMed]

15. Lenze EJ, Munin MC, Ferrell RE, Pollock BG, Skidmore E, Lotrich F, et al. Association of the Serotonin Transporter Gene-Linked Polymorphic Region (5-HTTLPR) Genotype With Depression in Elderly Persons After Hip Fracture. Am J Geriatr Psychiatry. 2005;13(5):428–32. [PubMed]

16. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561-71. [PubMed]

17. Williams LJ, Berk M, Henry MJ, Stuart AL, Brennan SL, Jacka FN, et al. Depression following fracture in women: a study of age-matched cohort. BMJ Open. 2014;4:e004226. [PubMed]

18. Wu Q, Liu J, Gallegos-Orozco JF, Hentz JG. Depression, fracture risk, and bone loss: A meta analysis of cohort studies. Osteoporosis international. 2010;21:1627-35. [PubMed]

19. Michael E. Mussolino. Depression and Hip Fracture Risk: The NHANES I Epidemiologic Follow-Up Study. Public Health Rep. 2005;120:71-75. [PubMed]

20. Forsen L, Haakon EM, Sogaard AJ, Naess S, Schei B, Edna TH. Mental distress and risk of hip fracture: do broken hearts lead to broken bones? J Epidemiol Community Health. 1999;53(6):343–7.

21. Pan HH, Li CY, Chen PC, Lee MD, Liang CY, Hou WH, et al. Contributions of diabetic macro-vascular complications and hip fracture to depression onset in elderly patients with diabetes: An 8-year population-based follow-up study. J Psychosom Res. 2012;73(3):180-4. [PubMed]

22. Lenze EJ, Munin MC, Skidmore ER, Dew MA, Rogers JC, Whyte EM, et al. Onset of Depression in Elderly Persons After Hip Fracture: Implications for Prevention and Early Intervention of Late-Life Depression. J Am Geriatr Soc. 2007;55(1): 81–6. [PubMed]

23. Broadhead WE, Blazer DG, George LK, Tse CK. Depression, disability days, and days lost from work in a prospective epidemiologic survey. JAMA. 1990;264(19):2524-8.

24. Hays RD, Wells KB, Sherbourne CD, Rogers W, Spritzer K. Functioning and wellbeing outcomes of patients with depression compared with chronic general medical illnesses. Arch Gen Psychiatry. 1995;52(1):11-9.

25. Mossey JM. Social and psychologic factors related to falls among the elderly. Clin Geriatr Med. 1985;1(3):541-53.

26. Cwikel J, Fried AV, Galinsky D. Falls and psychosocial factors among community dwelling elderly persons: a review and integration of findings from Israel. Public Health Rev.1989-1990;17(1):39-50.

27. Halbreich U, Rojansky N, Palter S, Hreshchyshyn M, Kreeger J, Bakhai Y, et al. Decreased bone mineral density in medicated psychiatric patients. Psychosom Med. 1995;57(5):485-91. [PubMed]

28. Cummings SR, Black DM, Nevitt MC, Browner W, Cauley J, Ensrud K, et al. Bone density at various sites for prediction of hip fractures: the Study of Osteoporotic Fractures Research Group. Lancet. 1993; 341(8837):72-5. [PubMed]

29. Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988; 319(26):1701-7. [PubMed]

30. Liu B, Anderson G, Mittmann N, Axcell T, To T, Schear N. Use of selective serotonin reuptake inhibitors or tricyclic antidepressants and risk of hip fractures in elderly people. Lancet. 1998; 351(9112):1303-7. [PubMed]

31. Mutran EJ, Reitzes DC, Mossey J, Fernandez ME. Social support, depression, and recovery of walking ability following hip fracture surgery. J Gerontol B Psychol Sci Soc Sci. 1995;50(6):S354-61. [PubMed]

32. Arinzon Z, Shabat S, Peisakh A, Gepstein R, Berner YN. Gender differences influence the outcome of Geriatric rehabilitation following hip fracture. Arch Gerontol Geriatr. 2010;50:86-91.

33. Cullum S, Metcalfe C, Todd C, Brayne C. Does depression predict adverse outcomes for older medical inpatients? A prospective cohort wtudy of individuals screened for a trial. Age and Ageing. 2008;37:690-5. [PubMed]

34. Lenze EJ, Munim MC, Dew MA, Rogers JC, Seligman K, Mulsant BH, et al. Adverse effects of Depression and cognitive impairment on rehabilitation participation and recovery from hip fracture. Int J Geriatr Psychiatry. 2004;19(5):472-8. [PubMed]

35. Hershkovitz A, Kalandariov Z, Hermush V, Weiss R, Brill S. Factors affecting short term rehabilitation outcomes of disabled elderly patients with proximal hip fracture. Arch Phys Med Rehabil. 2007;88:916-921.

36. Liberman D, Friger M, Liberman D. Inpatient rehabilitation outcome after hip fracture surgery in elderly patients; A prospective cohort study of 946 patients. Arch Phys Med Rehabil. 2006;87(2):167-171. [PubMed]

37. Lenze EJ, Skidmore ER, Dew MA, Butters MA, Rogers JC, Beagley A, et al. Does depression, apathy, or cognitive impairment reduce the benefit of inpatient rehabilitation facilities for elderly hip fracture patients? Gen Hosp Psychiatry. 2007;29:141-6. [PubMed]

38. Dennision E, Mohamed MA, Cooper C. Epidemiology of osteoporosis. Rheum Dis Clin North Am. 2006;32:617-29. [PubMed]

39. Pasco JA, Sanders KM, Hoekstra FM, Henry MJ, Nicholson GC, Kotowicz MA. The Human cost of fracture. Osteoporosis Int. 2005;16:2046-52. [PubMed]

40. Magaziner J, Simonsick EM, Kashner TM, Hebel JR, Kenzora JE. Predictors of functional recovery one year following hospital discharge for hip fracture: a prospective study. J Gerontol. 1990;45(3):M101-7. [PubMed]

41. Mossey JM, Knott K, Craik R. The effects of persistent depressive symptoms on hip fracture recovery. J Gerontol. 1990;45(5):M163-8. [PubMed]

42. Morrison R: The medical consultant’s role in caring for patients with hip fracture. Ann Intern Med. 1998;128:1010–20. [PubMed]

43. Duignan D, Woodward Y, Daniel E, Burns A. An intervention to manage depression after hip fracture. Nursing Times. 2007;103(28):32–33.
CITATION
DOI: 10.17511/ijmrr.2015.i7.133
Published: 2015-08-31
How to Cite
1.
PR S, KS R, Rajashekharaiah M. Depression Following Fracture in Adults: A Comparative Study between Men and Women at a Tertiary Care Centre. Int J Med Res Rev [Internet]. 2015Aug.31 [cited 2024Dec.22];3(7):706-11. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/306
Section
Original Article