{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T22:48:03Z","timestamp":1792018083344,"version":"4.4.0"},"reference-count":91,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2021,7,31]],"date-time":"2021-07-31T00:00:00Z","timestamp":1627689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Clinical psychological factors may predict medical diseases. Anxiety level has been associated with osteoporosis, but its role on bone mineral density (BMD) change is still unknown. This study aimed to investigate the association between anxiety levels and both adherence and treatment response to oral bisphosphonates (BPs) in postmenopausal osteoporosis. BMD and anxiety levels were evaluated trough dual-energy X-ray absorptiometry and the Hamilton Anxiety Rating Scale (HAM-A), respectively. Participants received weekly medication with alendronate or risedronate and were grouped according to the HAM-A scores into tertiles (HAM-A 3 &gt; HAM-A 2 &gt; HAM-A 1). After 24 months, BMD changes were different among the HAM-A tertiles. The median lumbar BMD change was significantly greater in both the HAM-A 2 and HAM-A 3 in comparison with the HAM-A 1. The same trend was observed for femoral BMD change. Adherence to BPs was &gt;75% in 68% of patients in the HAM-A 1, 79% of patients in the HAM-A 2, and 89% of patients in the HAM-A 3 (p = 0.0014). After correcting for age, body mass index, depressive symptoms, and the 10-yr. probability of osteoporotic fractures, anxiety levels independently predicted lumbar BMD change (\u03b2 = 0.3417, SE 0.145, p = 0.02). In conclusion, women with higher anxiety levels reported greater BMD improvement, highlighting that anxiety was associated with adherence and response to osteoporosis medical treatment, although further research on this topic is needed.<\/jats:p>","DOI":"10.3390\/ijerph18158144","type":"journal-article","created":{"date-parts":[[2021,8,1]],"date-time":"2021-08-01T21:51:07Z","timestamp":1627854667000},"page":"8144","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Anxiety Levels Predict Bone Mineral Density in Postmenopausal Women Undergoing Oral Bisphosphonates: A Two-Year Follow-Up"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9488-2021","authenticated-orcid":false,"given":"Gabriella","family":"Martino","sequence":"first","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University Hospital of Messina, 98122 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0467-4921","authenticated-orcid":false,"given":"Federica","family":"Bellone","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University Hospital of Messina, 98122 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmelo M.","family":"Vicario","sequence":"additional","affiliation":[{"name":"Department of Cognitive Sciences, Psychology, Education and Cultural Studies, University of Messina, 98121 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9958-9606","authenticated-orcid":false,"given":"Agostino","family":"Gaudio","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University Hospital of Catania, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3516-8332","authenticated-orcid":false,"given":"Andrea","family":"Caputo","sequence":"additional","affiliation":[{"name":"Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8253-5057","authenticated-orcid":false,"given":"Francesco","family":"Corica","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University Hospital of Messina, 98122 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Squadrito","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University Hospital of Messina, 98122 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0483-8594","authenticated-orcid":false,"given":"Peter","family":"Schwarz","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Research Centre for Ageing and Osteoporosis, Rigshospitalet-Glostrup Hospital, 2100 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nunziata","family":"Morabito","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University Hospital of Messina, 98122 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3890-2299","authenticated-orcid":false,"given":"Antonino","family":"Catalano","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University Hospital of Messina, 98122 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2502","DOI":"10.3389\/fpsyg.2019.02502","article-title":"Editorial: Psychological Factors as Determinants of Medical Conditions","volume":"10","author":"Martino","year":"2019","journal-title":"Front. Psychol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2026","DOI":"10.3389\/fpsyg.2020.02026","article-title":"The Relationship between Alexithymia and Type 2 Diabetes: A Systematic Review","volume":"11","author":"Martino","year":"2020","journal-title":"Front. Psychol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1779","DOI":"10.3389\/fpsyg.2019.01779","article-title":"As Time Goes by: Anxiety Negatively Affects the Perceived Quality of Life in Patients With Type 2 Diabetes of Long Duration","volume":"10","author":"Martino","year":"2019","journal-title":"Front. Psychol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.jad.2017.06.009","article-title":"Multimorbidity and Depression: A Systematic Review and Meta-Analysis","volume":"221","author":"Read","year":"2017","journal-title":"J. Affect. Disord."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Esteban, E., Coenen, M., Ito, E., Gruber, S., Scaratti, C., Leonardi, M., Roka, O., Vasilou, E., Mu\u00f1oz-Murillo, A., and \u00c1vila, C. (2018). Views and Experiences of Persons with Chronic Diseases about Strategies That Aim to Integrate and Re-Integrate Them into Work: A Systematic Review of Qualitative Studies. Int. J. Environ. Res. Public Health, 15.","DOI":"10.3390\/ijerph15051022"},{"key":"ref_6","unstructured":"Martino, G., Bellone, F., Langher, V., Caputo, A., Catalano, A., Quattropani, M.C., and Morabito, N. (2019). Alexithymia and Psychological Distress Affect Perceived Quality of Life in Patients with Type 2 Diabetes Mellitus. Mediterr. J. Clin. Psychol., 7."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"267","DOI":"10.3389\/fpsyg.2020.00267","article-title":"Going Beyond the Visible in Type 2 Diabetes Mellitus: Defense Mechanisms and Their Associations With Depression and Health-Related Quality of Life","volume":"11","author":"Martino","year":"2020","journal-title":"Front. Psychol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"645418","DOI":"10.3389\/fpsyg.2021.645418","article-title":"Roles of Anxiety and Depression in Predicting Cardiovascular Disease Among Patients With Type 2 Diabetes Mellitus: A Machine Learning Approach","volume":"12","author":"Chu","year":"2021","journal-title":"Front. Psychol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"200","DOI":"10.3389\/fpsyt.2019.00200","article-title":"Impacts of Psychological Stress on Osteoporosis: Clinical Implications and Treatment Interactions","volume":"10","author":"Kelly","year":"2019","journal-title":"Front Psychiatry"},{"key":"ref_10","first-page":"S140","article-title":"Transdiagnostic factors across fibromyalgia and mental disorders: Sleep disturbances may play a key role. A clinical review","volume":"34","author":"Palagini","year":"2016","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.jad.2011.12.042","article-title":"Plasma \u03b2-amyloid peptides levels: A pilot study in bipolar depressed patients","volume":"138","author":"Piccinni","year":"2012","journal-title":"J. Affect. Disord."},{"key":"ref_12","first-page":"136","article-title":"Methodological approach to depressive symptoms in fibromyalgia patients","volume":"30","author":"Veltri","year":"2012","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_13","first-page":"94","article-title":"Psychological distress among healthcare professionals involved in the COVID-19 emergency: Vulnerability and resilience factors","volume":"17","author":"Conversano","year":"2020","journal-title":"Clin. Neuropsychiatry J. Treat. Eval."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/s12991-014-0028-9","article-title":"New DSM-5 maladaptive symptoms in PTSD: Gender differences and correlations with mood spectrum symptoms in a sample of high school students following survival of an earthquake","volume":"13","author":"Carmassi","year":"2014","journal-title":"Ann. Gen. Psychiatry"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"REPOSI Investigators, Ardoino, I., Franchi, C., Nobili, A., Mannucci, P.M., and Corli, O. (2020). Pain and Frailty in Hospitalized Older Adults. Pain Ther., 9, 727\u2013740.","DOI":"10.1007\/s40122-020-00202-3"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Martino, G., Catalano, A., Agostino, R.M., Bellone, F., Morabito, N., Lasco, C.G., Vicario, C.M., Schwarz, P., and Feldt-Rasmussen, U. (2020). Quality of Life and Psychological Functioning in Postmenopausal Women Undergoing Aromatase Inhibitor Treatment for Early Breast Cancer. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0230681"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.3389\/fpsyg.2020.01763","article-title":"Alexithymia and Inflammatory Bowel Disease: A Systematic Review","volume":"11","author":"Martino","year":"2020","journal-title":"Front. Psychol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2155","DOI":"10.1007\/s00198-019-05104-5","article-title":"Determinants, Consequences and Potential Solutions to Poor Adherence to Anti-Osteoporosis Treatment: Results of an Expert Group Meeting Organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the International Osteoporosis Foundation (IOF)","volume":"30","author":"Hiligsmann","year":"2019","journal-title":"Osteoporos. Int."},{"key":"ref_19","unstructured":"World Health Organization (2003). Geneva Adherence to Long-Term Therapies: Evidence for Action, WHO."},{"key":"ref_20","first-page":"394","article-title":"Patients\u2019 Adherence to Osteoporosis Therapy: Exploring the Perceptions of Postmenopausal Women","volume":"54","author":"Lau","year":"2008","journal-title":"Can. Fam. Physician"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1001\/jamainternmed.2015.7667","article-title":"Mobile Telephone Text Messaging for Medication Adherence in Chronic Disease: A Meta-Analysis","volume":"176","author":"Thakkar","year":"2016","journal-title":"JAMA Intern. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e13350","DOI":"10.1111\/ijcp.13350","article-title":"Prevalence of and Factors Associated with Primary Medication Non-adherence in Chronic Disease: A Systematic Review and Meta-analysis","volume":"73","author":"Cheen","year":"2019","journal-title":"Int. J. Clin. Pract."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"The EU Review Panel of the IOF, Svedbom, A., Hernlund, E., Iverg\u00e5rd, M., Compston, J., Cooper, C., Stenmark, J., McCloskey, E.V., J\u00f6nsson, B., and Kanis, J.A. (2013). Osteoporosis in the European Union: A Compendium of Country-Specific Reports. Arch. Osteoporos., 8, 137.","DOI":"10.1007\/s11657-013-0137-0"},{"key":"ref_24","first-page":"191","article-title":"Fracture Risk Assessment in Postmenopausal Women Referred to an Italian Center for Osteoporosis: A Single Day Experience in Messina","volume":"10","author":"Catalano","year":"2013","journal-title":"Clin. Cases Miner Bone Metab."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1007\/s00198-006-0224-9","article-title":"Incidence and Costs of Hip Fractures Compared to Acute Myocardial Infarction in the Italian Population: A 4-Year Survey","volume":"18","author":"Piscitelli","year":"2007","journal-title":"Osteoporos. Int."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1007\/s40266-017-0492-4","article-title":"Pain in Osteoporosis: From Pathophysiology to Therapeutic Approach","volume":"34","author":"Catalano","year":"2017","journal-title":"Drugs Aging"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.jad.2016.06.052","article-title":"Anxiety Disorders and Falls among Older Adults","volume":"205","author":"Holloway","year":"2016","journal-title":"J. Affect. Disord."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1097\/PSY.0000000000000114","article-title":"Life Satisfaction and Bone Mineral Density Among Postmenopausal Women: Cross-Sectional and Longitudinal Associations","volume":"76","author":"Rauma","year":"2014","journal-title":"Psychosom. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1007\/s11739-011-0628-1","article-title":"Bone Mineral Density, Quantitative Ultrasound Parameters and Bone Metabolism in Postmenopausal Women with Depression","volume":"8","author":"Atteritano","year":"2013","journal-title":"Intern. Emerg. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2251","DOI":"10.1007\/s40520-019-01426-w","article-title":"Executive Functions Predict Fracture Risk in Postmenopausal Women Assessed for Osteoporosis","volume":"32","author":"Catalano","year":"2020","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Martino, G., Sardella, A., Bellone, F., Lasco, C., Langher, V., Cazzato, V., Penna, A., Vicario, C., Morabito, N., and Catalano, A. (2019). Executive Functions and Bone Health: A Focus on Cognitive Impulsivity and Bone Mineral Density. Mediterr. J. Clin. Psychol., 7.","DOI":"10.1136\/annrheumdis-2019-eular.4257"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1007\/s11657-012-0105-0","article-title":"The Relationship of Depression, Anxiety and Stress with Low Bone Mineral Density in Post-Menopausal Women","volume":"7","author":"Erez","year":"2012","journal-title":"Arch. Osteoporos."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.jad.2010.11.019","article-title":"The Association between Depressive and Anxiety Symptoms and Bone Mineral Density in the General Population: The HUNT Study","volume":"131","author":"Williams","year":"2011","journal-title":"J. Affect. Disord."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e4912","DOI":"10.1097\/MD.0000000000004912","article-title":"The Incidence and Risk of Osteoporosis in Patients with Anxiety Disorder: A Population-Based Retrospective Cohort Study","volume":"95","year":"2016","journal-title":"Medicine"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1097\/GME.0000000000001123","article-title":"Anxiety Levels Predict Fracture Risk in Postmenopausal Women Assessed for Osteoporosis","volume":"25","author":"Catalano","year":"2018","journal-title":"Menopause"},{"key":"ref_36","unstructured":"Martino, G., Catalano, A., Bellone, F., Sardella, A., Lasco, C., Capr\u00ec, T., Langher, V., Caputo, A., Fabio, R.A., and Morabito, N. (2018). Vitamin D Status Is Associated with Anxiety Levels in Postmenopausal Women Evaluated for Osteoporosis. Mediterr. J. Clin. Psychol., 6."},{"key":"ref_37","unstructured":"Martino, G., Catalano, A., Bellone, F., Langher, V., Lasco, C., Penna, A., Nicocia, G., and Morabito, N. (2018). Quality of Life in Postmenopausal Women: Which Role for Vitamin D?. Mediterr. J. Clin. Psychol., 6."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Di Bari, F., Catalano, A., Bellone, F., Martino, G., and Benvenga, S. (2021). Vitamin D, Bone Metabolism, and Fracture Risk in Polycystic Ovary Syndrome. Metabolites, 11.","DOI":"10.3390\/metabo11020116"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1595","DOI":"10.1210\/jc.2019-00221","article-title":"Pharmacological Management of Osteoporosis in Postmenopausal Women: An Endocrine Society* Clinical Practice Guideline","volume":"104","author":"Eastell","year":"2019","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1007\/s40618-016-0434-8","article-title":"Italian Association of Clinical Endocrinologists (AME) Position Statement: Drug Therapy of Osteoporosis","volume":"39","author":"Vescini","year":"2016","journal-title":"J. Endocrinol. Investig."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/s40618-014-0152-z","article-title":"Treatment of Post-Menopausal Osteoporosis: Beyond Bisphosphonates","volume":"38","author":"Ishtiaq","year":"2015","journal-title":"J. Endocrinol. Investig."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"3655","DOI":"10.1007\/s00198-016-3761-x","article-title":"Effects of Teriparatide on Bone Mineral Density and Quality of Life in Duchenne Muscular Dystrophy Related Osteoporosis: A Case Report","volume":"27","author":"Catalano","year":"2016","journal-title":"Osteoporos. Int."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association American Psychiatric Association. [5th ed.].","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1111\/j.2044-8341.1959.tb00467.x","article-title":"The Assessment of Anxiety States by Rating","volume":"32","author":"Hamilton","year":"1959","journal-title":"Br. J. Med Psychol."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Beck, A.T., Steer, R.A., and Brown, G.K. (1996). Manual for the Beck Depression Inventory\u2013II, Pearson.","DOI":"10.1037\/t00742-000"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1097\/GME.0000000000000722","article-title":"Bone Health Assessment by Quantitative Ultrasound and Dual-Energy x-Ray Absorptiometry in Postmenopausal Women with Breast Cancer Receiving Aromatase Inhibitors","volume":"24","author":"Catalano","year":"2017","journal-title":"Menopause"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1007\/s40618-019-01063-0","article-title":"Trabecular Bone Score and Quantitative Ultrasound Measurements in the Assessment of Bone Health in Breast Cancer Survivors Assuming Aromatase Inhibitors","volume":"42","author":"Catalano","year":"2019","journal-title":"J. Endocrinol. Investig."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/s11739-018-1874-2","article-title":"Guidelines for the Management of Osteoporosis and Fragility Fractures","volume":"14","author":"Nuti","year":"2019","journal-title":"Intern. Emerg. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1016\/j.bbi.2017.01.021","article-title":"Peripheral Inflammatory Cytokines and Immune Balance in Generalised Anxiety Disorder: Case-Controlled Study","volume":"62","author":"Hou","year":"2017","journal-title":"Brain Behav. Immun."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1007\/s00441-010-1086-1","article-title":"Osteoblast Physiology in Normal and Pathological Conditions","volume":"343","author":"Neve","year":"2011","journal-title":"Cell Tissue Res."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.jad.2007.07.025","article-title":"Abnormal Reactions to Environmental Stress in Elderly Persons with Anxiety Disorders: Evidence from a Population Study of Diurnal Cortisol Changes","volume":"106","author":"Chaudieu","year":"2008","journal-title":"J. Affect. Disord."},{"key":"ref_52","first-page":"352","article-title":"Subclinical Hypercortisol-Assessment of Bone Fragility: Experience of Single Osteoporosis Center in Sicily","volume":"18","author":"Lasco","year":"2014","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1124\/jpet.116.237503","article-title":"Oxidative Stress and the Central Nervous System","volume":"360","author":"Salim","year":"2017","journal-title":"J. Pharmacol. Exp. Ther."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1016\/j.psychres.2015.11.001","article-title":"Evaluation of Oxidative and Antioxidative Parameters in Generalized Anxiety Disorder","volume":"230","author":"Emhan","year":"2015","journal-title":"Psychiatry Res."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2016\/7067984","article-title":"Oxidative Stress-Related Biomarkers in Postmenopausal Osteoporosis: A Systematic Review and Meta-Analyses","volume":"2016","author":"Zhou","year":"2016","journal-title":"Dis. Markers"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1007\/s00198-007-0410-4","article-title":"Adherence to Treatment of Osteoporosis: A Need for Study","volume":"18","author":"Lekkerkerker","year":"2007","journal-title":"Osteoporos. Int."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"4","DOI":"10.4081\/reumatismo.2009.4","article-title":"Adherence to Treatment of Osteoporosis: An Open Question","volume":"61","author":"Varenna","year":"2011","journal-title":"Reumatismo"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.1007\/s00198-015-3038-9","article-title":"Improving Adherence to and Persistence with Oral Therapy of Osteoporosis","volume":"26","author":"Bianchi","year":"2015","journal-title":"Osteoporos. Int."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1007\/s00198-006-0073-6","article-title":"Determinants of Adherence to Osteoporosis Treatment in Clinical Practice","volume":"17","author":"Rossini","year":"2006","journal-title":"Osteoporos. Int."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"2303","DOI":"10.1517\/14656560903140533","article-title":"Poor Adherence to Oral Bisphosphonate Treatment and Its Consequences: A Review of the Evidence","volume":"10","author":"Rabenda","year":"2009","journal-title":"Expert Opin. Pharmacother."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Adherence Working Group of the International Osteoporosis Foundation, The European Calcified Tissue Society, Diez-Perez, A., Naylor, K.E., Abrahamsen, B., Agnusdei, D., Brandi, M.L., Cooper, C., Dennison, E., and Eriksen, E.F. (2017). International Osteoporosis Foundation and European Calcified Tissue Society Working Group. Recommendations for the Screening of Adherence to Oral Bisphosphonates. Osteoporos. Int., 28, 767\u2013774.","DOI":"10.1007\/s00198-017-3906-6"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1627","DOI":"10.1007\/s00198-019-05010-w","article-title":"Patients\u2019 Reasons for Adhering to Long-Term Alendronate Therapy","volume":"30","author":"Pepe","year":"2019","journal-title":"Osteoporos. Int."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1986","DOI":"10.1016\/j.joms.2020.05.037","article-title":"Can Surgical Management Improve Resolution of Medication-Related Osteonecrosis of the Jaw at Early Stages? A Prospective Cohort Study","volume":"78","author":"Giudice","year":"2020","journal-title":"J. Oral Maxillofac. Surg. Off. J. Am. Assoc. Oral Maxillofac. Surg."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"813","DOI":"10.4103\/ijdr.IJDR_689_19","article-title":"Usefulness of advanced-platelet rich fibrin (A-PRF) and injectable-platelet rich fibrin (i-PRF) in the management of a massive medication-related osteonecrosis of the jaw (MRONJ): A 5-years follow-up case report","volume":"31","author":"Giudice","year":"2020","journal-title":"Indian J. Dent. Res. Off. Publ. Indian Soc. Dent. Res."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Di Vito, A., Chiarella, E., Baudi, F., Scardamaglia, P., Antonelli, A., Giudice, D., Barni, T., Fortunato, L., and Giudice, A. (2020). Dose-Dependent Effects of Zoledronic Acid on Human Periodontal Ligament Stem Cells: An In Vitro Pilot Study. Cell Transplant., 29.","DOI":"10.1177\/0963689720948497"},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Giudice, A., Antonelli, A., Chiarella, E., Baudi, F., Barni, T., and Di Vito, A. (2020). The Case of Medication-Related Osteonecrosis of the Jaw Addressed from a Pathogenic Point of View. Innovative Therapeutic Strategies: Focus on the Most Recent Discoveries on Oral Mesenchymal Stem Cell-Derived Exosomes. Pharmaceuticals, 13.","DOI":"10.3390\/ph13120423"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"2623","DOI":"10.1007\/s00198-018-4759-3","article-title":"A Systematic Review of Factors Affecting Medication Adherence among Patients with Osteoporosis","volume":"29","author":"Yeam","year":"2018","journal-title":"Osteoporos. Int."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"635708","DOI":"10.3389\/fpsyg.2021.635708","article-title":"Psychological Factors as Determinants of Chronic Conditions: Clinical and Psychodynamic Advances","volume":"12","author":"Conversano","year":"2021","journal-title":"Front. Psychol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1007\/s11469-018-0008-4","article-title":"The Experience of Therapeutic Community: Emotional and Motivational Dynamics of People with Drug Addiction Following Rehabilitation","volume":"17","author":"Caputo","year":"2019","journal-title":"Int. J. Ment. Health Addict."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Grochans, E., Szkup, M., Kotwas, A., Kope\u0107, J., Karakiewicz, B., and Jurczak, A. (2018). Analysis of Sociodemographic, Psychological, and Genetic Factors Contributing to Depressive Symptoms in Pre-, Peri- and Postmenopausal Women. Int. J. Environ. Res. Public Health, 15.","DOI":"10.3390\/ijerph15040712"},{"key":"ref_71","first-page":"23","article-title":"Emotional Dynamics of Persons with Type 2 Diabetes and Their Potential Role in Treatment Adherence: Insights from a Clinical Psychodynamic Perspective","volume":"37","author":"Marchini","year":"2020","journal-title":"Psychology Hub"},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Marchini, F., Langher, V., Napoli, A., Balonan, J.T., Fedele, F., Martino, G., Amorosi, F.R., and Caputo, A. (2021). Unconscious loss processing in diabetes: Associations with medication adherence and quality of care. Psychol. Psychother., 1\u201319.","DOI":"10.1080\/02668734.2021.1922492"},{"key":"ref_73","first-page":"217","article-title":"Retrospective Analyses of Psychological Distress and Defense Style among Cancer Patients","volume":"17","author":"Conversano","year":"2020","journal-title":"Clin. Neuropsychiatry"},{"key":"ref_74","unstructured":"(2021, March 10). L\u2019uso Dei Farmaci in Italia 2019, Available online: https:\/\/www.aifa.gov.it\/uso-dei-farmaci-in-italia."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1645","DOI":"10.1007\/s00198-020-05378-0","article-title":"Interventions to Improve Adherence to Anti-Osteoporosis Medications: An Updated Systematic Review","volume":"31","author":"Cornelissen","year":"2020","journal-title":"Osteoporos. Int."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1016\/S0140-6736(96)07088-2","article-title":"Randomised Trial of Effect of Alendronate on Risk of Fracture in Women with Existing Vertebral Fractures","volume":"348","author":"Black","year":"1996","journal-title":"Lancet"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"2077","DOI":"10.1001\/jama.280.24.2077","article-title":"Effect of Alendronate on Risk of Fracture in Women with Low Bone Density but without Vertebral Fractures: Results from the Fracture Intervention Trial","volume":"280","author":"Cummings","year":"1998","journal-title":"JAMA"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.1001\/jama.282.14.1344","article-title":"Effects of Risedronate Treatment on Vertebral and Nonvertebral Fractures in Women With Postmenopausal OsteoporosisA Randomized Controlled Trial","volume":"282","author":"Harris","year":"1999","journal-title":"JAMA"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1007\/s001980050010","article-title":"Randomized Trial of the Effects of Risedronate on Vertebral Fractures in Women with Established Postmenopausal Osteoporosis. Vertebral Efficacy with Risedronate Therapy (VERT) Study Group","volume":"11","author":"Reginster","year":"2000","journal-title":"Osteoporos. Int."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1056\/NEJM200102013440503","article-title":"Effect of Risedronate on the Risk of Hip Fracture in Elderly Women. Hip Intervention Program Study Group","volume":"344","author":"McClung","year":"2001","journal-title":"N. Engl. J. Med."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"1809","DOI":"10.1056\/NEJMoa067312","article-title":"Once-Yearly Zoledronic Acid for Treatment of Postmenopausal Osteoporosis","volume":"356","author":"Black","year":"2007","journal-title":"N. Engl. J. Med."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1359\/JBMR.040325","article-title":"Effects of Oral Ibandronate Administered Daily or Intermittently on Fracture Risk in Postmenopausal Osteoporosis","volume":"19","author":"Chesnut","year":"2004","journal-title":"J. Bone Miner Res."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1565","DOI":"10.1359\/jbmr.060715","article-title":"Fracture Incidence and Characterization in Patients on Osteoporosis Treatment: The ICARO Study","volume":"21","author":"Adami","year":"2006","journal-title":"J. Bone Miner Res."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1007\/s00198-008-0650-y","article-title":"Vitamin D Status and Response to Treatment in Post-Menopausal Osteoporosis","volume":"20","author":"Adami","year":"2009","journal-title":"Osteoporos. Int."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1007\/s00223-009-9295-x","article-title":"Minimum Required Vitamin D Level for Optimal Increase in Bone Mineral Density with Alendronate Treatment in Osteoporotic Women","volume":"85","author":"Ishijima","year":"2009","journal-title":"Calcif. Tissue Int."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1007\/s40618-015-0299-2","article-title":"Vitamin D and Bone Mineral Density Changes in Postmenopausal Women Treated with Strontium Ranelate","volume":"38","author":"Catalano","year":"2015","journal-title":"J. Endocrinol. Investig."},{"key":"ref_87","doi-asserted-by":"crossref","unstructured":"Catalano, A., Bellone, F., Santoro, D., Schwarz, P., Gaudio, A., Basile, G., Sottile, M.C., Stoian, S.A., Corica, F., and Morabito, N. (2021). Vitamin D Boosts Alendronate Tail Effect on Bone Mineral Density in Postmenopausal Women with Osteoporosis. Nutrients, 13.","DOI":"10.3390\/nu13061878"},{"key":"ref_88","doi-asserted-by":"crossref","unstructured":"Tecilazich, F., Formenti, A.M., and Giustina, A. (2020). Role of Vitamin D in Diabetic Retinopathy: Pathophysiological and Clinical Aspects. Rev. Endocr. Metab. Disord.","DOI":"10.1007\/s11154-020-09575-4"},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"Zarei, M., Zarezadeh, M., Hamedi Kalajahi, F., and Javanbakht, M.H. (2020). The Relationship Between Vitamin D and Telomere\/Telomerase: A Comprehensive Review. J. Frailty Aging, 1\u20138.","DOI":"10.14283\/jfa.2020.33"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1007\/s40618-019-01057-y","article-title":"Vitamin D Status and Cardiovascular Outcome","volume":"42","author":"Saponaro","year":"2019","journal-title":"J. Endocrinol. Investig."},{"key":"ref_91","doi-asserted-by":"crossref","unstructured":"Giannini, S., Passeri, G., Tripepi, G., Sella, S., Fusaro, M., Arcidiacono, G., Torres, M.O., Michielin, A., Prandini, T., and Baffa, V. (2021). Effectiveness of In-Hospital Cholecalciferol Use on Clinical Outcomes in Comorbid COVID-19 Patients: A Hypothesis-Generating Study. Nutrients, 13.","DOI":"10.3390\/nu13010219"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/15\/8144\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:38:35Z","timestamp":1760164715000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/15\/8144"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,31]]},"references-count":91,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2021,8]]}},"alternative-id":["ijerph18158144"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18158144","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,31]]}}}