OBJECTIVES: : Depression is a chronic debilitating disease with high prevalence that considerably affects quality of life. The relationship between depression and osteoporosis has been demonstrated, but the evidence is heterogeneous. The aim of the present study is to investigate about this relationship in the Italian primary care setting. METHODS: This was a retrospective analysis based on data extracted from Italian IMS Health Longitudinal Patient Database. Two cohorts have been defined: patients with a diagnosis of Depression (Index Date) during the period January 2004 -  December 2010 and without neither Depression neither Osteoporosis diagnosis during the 5 years period preceeding the Index Date; patients with a first contact (Index Date) during the period January 2004 -  December 2010 that are not in the previous cohort (free from Depression) and without neither Osteoporosis neither Depression diagnosis during the five years period preceeding the Index Date. Patients in both the two cohorts have been followed-up until one of the following event occurred first: Osteoporosis diagnosis registration, death, end of registration with the GP, 31 December 2013. Osteoporosis incidence rates have been separately calculated in the two cohorts and Osteoporosis cumulative incidence curves have been estimated using Kaplan Meier methods and compared  performing log rank tests. Both univariate and multivariate Cox proportional hazard models were performed. RESULTS:  Osteoporosis incidence was higher in the cohort of depressed patients (2.33 cases per 100 person years vs 1.22 cases per 100 person years) and  results were confirmed by the log rank test (p<0.001). Increased risk of developing osteoporosis for depressed patients was shown both by univariate proportional hazard model (HR=1.75, CI=[1.72,1.78]) and multivariate proportional hazard model (HR=1.15, CI=[1.13, 1.17]). CONCLUSIONS: Results from this study suggests that the relationship between Depression and Osteoporosis is confirmed also in the primary care setting in Italy.