Abstract
BackgroundThe primary aim was to examine possible differences in telomere length between primary health care patients, with depression, anxiety or stress and adjustment disorders, and healthy controls. The second aim was to examine the association between telomere length and baseline characteristics in the patients. The third aim was to examine the potential effects of the 8-week treatments (mindfulness-based group therapy or treatment as usual, i.e. mostly cognitive-based therapy) on telomere length, and to examine whether there was a difference in the potential effect on telomere length between the two groups.MethodsA total of 501 individuals including 181 patients (aged 20–64 years), with depression, anxiety and stress and adjustment disorders, and 320 healthy controls (aged 19–70 years) were recruited in the study. Patient data were collected from a randomized controlled trial comparing mindfulness-based group therapy with treatment as usual. We isolated genomic DNA from blood samples, collected at baseline and after the 8-week follow-up. Telomere length was measured by quantitative real-time (qRT)-PCR.ResultsTelomere length was significantly shorter in the patients (mean = 0.77 ± 0.12,), compared to the controls (mean = 0.81 ± 0.14) (p = 0.006). The difference in telomere length remained significant after controlling for age and sex. Old age, male sex and being overweight were associated with shorter telomere length. There was no significant difference in telomere length between baseline and at the 8-week follow-up in any of the treatment groups and no difference between the two groups.ConclusionOur findings confirm that telomere length, as compared with healthy controls, is shortened in patients with depression, anxiety and stress and adjustment disorders. In both groups (mindfulness-based group therapy or treatment as usual), the telomere length remained unchanged after the 8-week treatment/follow-up and there was no difference between the two groups.Trial registration(ClinicalTrials.gov ID: NCT01476371) Registered November 11, 2011.
Highlights
The primary aim was to examine possible differences in telomere length between primary health care patients, with depression, anxiety or stress and adjustment disorders, and healthy controls
The potential effect of the 8-week treatment on telomere length Paired T-tests were used to examine the potential effect of the treatment on telomere length in the patients. This analysis showed that the telomere length remained unchanged after the 8-week treatment in both the mindfulness and the TAU group (p = 0.21 and p = 0.79, respectively, Table 4) and there was no difference between the two groups (p = 0.34, Table 5)
We found that old age, male sex and being overweight were associated with shortened telomere length in the patient group, we did not find significant associations between telomere length and the other variables in the analyses of the associations between telomere length and baseline characteristic within the patient group
Summary
The primary aim was to examine possible differences in telomere length between primary health care patients, with depression, anxiety or stress and adjustment disorders, and healthy controls. Depression, anxiety, and stress and adjustment disorders are common psychiatric disorders, with an estimated prevalence that varies between 12 and 32% of the total medical practice consultations in primary care in Europe [1, 2]. Telomeres shorten during somatic cell division because DNA polymerase is unable to fully replicate the 3′ end of DNA. This process can be reversed by an enzyme (telomerase) that is only active in certain replicating tissues, such as male germ cells and activated lymphocytes, stem cells and cancer cells [17, 18]. Shorter telomere length has been linked to the development of a variety of age-related diseases, such as cancer [22, 23], cardiovascular disease [24, 25] and diabetes [26]; diseases that are associated with common psychiatric disorders [3,4,5,6,7,8,9,10]
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