Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-24T21:49:59.611Z Has data issue: false hasContentIssue false
  • English
  • Français

Association between anxiety but not depressive disorders and leukocyte telomere length after 2 years of follow-up in a population-based sample

Published online by Cambridge University Press:  09 August 2012

P. W. Hoen ,
J. G. M. Rosmalen ,
R. A. Schoevers ,
J. Huzen ,
P. van der Harst  and
P. de Jonge
P. W. Hoen*
Affiliation:
Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, The Netherlands
J. G. M. Rosmalen
Affiliation:
Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, The Netherlands
R. A. Schoevers
Affiliation:
Department of Psychiatry, University Medical Center Groningen, University of Groningen, The Netherlands
J. Huzen
Affiliation:
Department of Psychiatry, University Medical Center Groningen, University of Groningen, The Netherlands
P. van der Harst
Affiliation:
Department of Cardiology, University Medical Center Groningen, University of Groningen, The Netherlands
P. de Jonge
Affiliation:
Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, The Netherlands
*
*Address for correspondence: P. W. Hoen, B.Sc., University Medical Center Groningen, Interdisciplinary Center for Psychiatric Epidemiology, CC72, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Telomere length is considered an emerging marker of biological aging. Depression and anxiety are associated with excess mortality risk but the mechanisms remain obscure. Telomere length might be involved because it is associated with psychological distress and mortality. The aim of this study was to test whether anxiety and depressive disorders predict telomere length over time in a large population-based sample.

Method

All analyses were performed in a longitudinal study in a general population cohort of 974 participants. The Composite International Diagnostic Interview (CIDI) was used to measure the presence of anxiety and depressive disorders. Telomere length was measured using monochrome multiplex polymerase chain reaction (PCR) at approximately 2 years of follow-up. We used linear multivariable regression models to evaluate the association between anxiety and depressive disorders and telomere length, adjusting for adverse life events, lifestyle factors, educational level and antidepressant use.

Results

The presence of anxiety disorders predicted shorter telomeres at follow-up (β = –0.073, t = –2.302, p = 0.022). This association was similar after controlling for adverse life events, lifestyle factors, educational level and antidepressant use (β = –0.077, t = –2.144, p = 0.032). No association was found between depressive disorders and shorter telomeres at follow-up (β = 0.010, t = 0.315, p = 0.753).

Conclusions

This study found that anxiety disorders predicted shorter telomere length at follow-up in a general population cohort. The association was not explained by adverse life events, lifestyle factors, educational level and antidepressant use. How anxiety disorders might lead to accelerated telomere shortening and whether this might be a mediator explaining the excess mortality risk associated with anxiety deserve further investigation.

Keywords

Anxiety disordersdepressive disorderslongitudinaltelomere length.
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 4 , April 2013 , pp. 689 - 697
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andrews, G, Peters, L (1998). The psychometric properties of the Composite International Diagnostic Interview. Social Psychiatry and Psychiatric Epidemiology 33, 80–88.CrossRefGoogle ScholarPubMed
Angst, F, Stassen, HH, Clayton, PJ, Angst, J (2002). Mortality of patients with mood disorders: follow-up over 34–38 years. Journal of Affective Disorders 68, 167–181.CrossRefGoogle ScholarPubMed
Bekaert, S, De Meyer, T, Rietzschel, ER, De Buyzere, ML, De Bacquer, D, Langlois, M, Segers, P, Cooman, L, Van Damme, P, Cassiman, P, Van Criekinge, W, Verdonck, P, De Backer, GG, Gillebert, TC, Van Oostveldt, P, Asklepios investigators (2007). Telomere length and cardiovascular risk factors in a middle-aged population free of overt cardiovascular disease. Aging Cell 6, 639–647.CrossRefGoogle Scholar
Blackburn, EH (2001). Switching and signaling at the telomere. Cell 106, 661–673.CrossRefGoogle ScholarPubMed
Bonnet, F, Irving, K, Terra, JL, Nony, P, Berthezene, F, Moulin, P (2005). Anxiety and depression are associated with unhealthy lifestyle in patients at risk of cardiovascular disease. Atherosclerosis 178, 339–344.CrossRefGoogle ScholarPubMed
Brugha, T, Bebbington, P, Tennant, C, Hurry, J (1985). The List of Threatening Experiences: a subset of 12 life event categories with considerable long-term contextual threat. Psychological Medicine 15, 189–194.CrossRefGoogle ScholarPubMed
Cawthon, RM (2009). Telomere length measurement by a novel monochrome multiplex quantitative PCR method. Nucleic Acids Research 37, e21.CrossRefGoogle ScholarPubMed
Cherkas, LF, Hunkin, JL, Kato, BS, Richards, JB, Gardner, JP, Surdulescu, GL, Kimura, M, Lu, X, Spector, TD, Aviv, A (2008). The association between physical activity in leisure time and leukocyte telomere length. Archives of Internal Medicine 168, 154–158.CrossRefGoogle ScholarPubMed
Craske, MG, Rauch, SL, Ursano, R, Prenoveau, J, Pine, DS, Zinbarg, RE (2009). What is an anxiety disorder? Depression and Anxiety 26, 1066–1085.CrossRefGoogle ScholarPubMed
Damjanovic, AK, Yang, Y, Glaser, R, Kiecolt-Glaser, JK, Nguyen, H, Laskowski, B, Zou, Y, Beversdorf, DQ, Weng, NP (2007). Accelerated telomere erosion is associated with a declining immune function of caregivers of Alzheimer's disease patients. Journal of Immunology 179, 4249–4254.CrossRefGoogle ScholarPubMed
Denollet, J, Maas, K, Knottnerus, A, Keyzer, JJ, Pop, VJ (2009). Anxiety predicted premature all-cause and cardiovascular death in a 10-year follow-up of middle-aged women. Journal of Clinical Epidemiology 62, 452–456.CrossRefGoogle Scholar
Dia, DA, Harrington, D, Silverman, WK (2010). An examination of the tripartite model of anxiety and depression in an outpatient sample of adolescents. Journal of Evidence-Based Social Work 7, 302–312.CrossRefGoogle Scholar
Epel, ES, Blackburn, EH, Lin, J, Dhabhar, FS, Adler, NE, Morrow, JD, Cawthon, RM (2004). Accelerated telomere shortening in response to life stress. Proceedings of the National Academy of Sciences USA 101, 17312–17315.CrossRefGoogle ScholarPubMed
Forlenza, MJ, Miller, GE (2006). Increased serum levels of 8-hydroxy-2′-deoxyguanosine in clinical depression. Psychosomatic Medicine 68, 1–7.CrossRefGoogle ScholarPubMed
Hartmann, N, Boehner, M, Groenen, F, Kalb, R (2010). Telomere length of patients with major depression is shortened but independent from therapy and severity of the disease. Depression and Anxiety 27, 1111–1116.CrossRefGoogle ScholarPubMed
Kananen, L, Surakka, I, Pirkola, S, Suvisaari, J, Lonnqvist, J, Peltonen, L, Ripatti, S, Hovatta, I (2010). Childhood adversities are associated with shorter telomere length at adult age both in individuals with an anxiety disorder and controls. PloS One 5, e10826.CrossRefGoogle ScholarPubMed
Kim, S, Parks, CG, DeRoo, LA, Chen, H, Taylor, JA, Cawthon, RM, Sandler, DP (2009). Obesity and weight gain in adulthood and telomere length. Cancer Epidemiology, Biomarkers and Prevention 18, 816–820.CrossRefGoogle ScholarPubMed
Kurz, DJ, Decary, S, Hong, Y, Trivier, E, Akhmedov, A, Erusalimsky, JD (2004). Chronic oxidative stress compromises telomere integrity and accelerates the onset of senescence in human endothelial cells. Journal of Cell Science 117, 2417–2426.CrossRefGoogle ScholarPubMed
Lung, FW, Chen, NC, Shu, BC (2007). Genetic pathway of major depressive disorder in shortening telomeric length. Psychiatric Genetics 17, 195–199.CrossRefGoogle ScholarPubMed
Monster, TB, Janssen, WM, de Jong, PE, de Jong-van den, Berg LT, PREVEND Study Group Prevention of REnal and Vascular END Stage Disease (2002). Pharmacy data in epidemiological studies: an easy to obtain and reliable tool. Pharmacoepidemiology and Drug Safety 11, 379–384.CrossRefGoogle ScholarPubMed
Morla, M, Busquets, X, Pons, J, Sauleda, J, MacNee, W, Agusti, AG (2006). Telomere shortening in smokers with and without COPD. European Respiratory Journal 27, 525–528.CrossRefGoogle ScholarPubMed
O'Brien, SM, Scott, LV, Dinan, TG (2004). Cytokines: abnormalities in major depression and implications for pharmacological treatment. Human Psychopharmacology 19, 397–403.CrossRefGoogle ScholarPubMed
O'Donovan, A, Pantell, MS, Puterman, E, Dhabhar, FS, Blackburn, EH, Yaffe, K, Cawthon, RM, Opresko, PL, Hsueh, WC, Satterfield, S, Newman, AB, Ayonayon, HN, Rubin, SM, Harris, TB, Epel, ES, for the Health Aging and Body Composition Study (2011). Cumulative inflammatory load is associated with short leukocyte telomere length in the Health, Aging and Body Composition Study. PloS One 6, e19687.CrossRefGoogle ScholarPubMed
Olovnikov, AM (1996). Telomeres, telomerase, and aging: origin of the theory. Experimental Gerontology 31, 443–448.CrossRefGoogle ScholarPubMed
Pinto-Sietsma, SJ, Janssen, WM, Hillege, HL, Navis, G, De Zeeuw, D, De Jong, PE (2000). Urinary albumin excretion is associated with renal functional abnormalities in a nondiabetic population. Journal of the American Society of Nephrology 11, 1882–1888.CrossRefGoogle Scholar
Rammal, H, Bouayed, J, Younos, C, Soulimani, R (2008). Evidence that oxidative stress is linked to anxiety-related behaviour in mice. Brain, Behavior, and Immunity 22, 1156–1159.CrossRefGoogle ScholarPubMed
Roest, AM, Martens, EJ, de Jonge, P, Denollet, J (2010). Anxiety and risk of incident coronary heart disease: a meta-analysis. Journal of the American College of Cardiology 56, 38–46.CrossRefGoogle ScholarPubMed
Rosmalen, JGM, Bos, EH, de Jonge, P (2012). Validation of the Long-term Difficulties Inventory (LDI) and the List of Threatening Experiences (LTE) as measures of stress in epidemiological population-based cohort studies. Psychological Medicine. Published online 11 April 2012. doi:10.1017/S0033291712000608.CrossRefGoogle ScholarPubMed
Schoevers, RA, Geerlings, MI, Deeg, DJ, Holwerda, TJ, Jonker, C, Beekman, AT (2009). Depression and excess mortality: evidence for a dose response relation in community living elderly. International Journal of Geriatric Psychiatry 24, 169–176.CrossRefGoogle ScholarPubMed
Shiels, PG, McGlynn, LM, MacIntyre, A, Johnson, PC, Batty, GD, Burns, H, Cavanagh, J, Deans, KA, Ford, I, McConnachie, A, McGinty, A, McLean, JS, Millar, K, Sattar, N, Tannahill, C, Velupillai, YN, Packard, CJ (2011). Accelerated telomere attrition is associated with relative household income, diet and inflammation in the pSoBid cohort. PloS One 6, e22521.CrossRefGoogle ScholarPubMed
Simon, GE, Katon, WJ, Lin, EH, Rutter, C, Manning, WG, Von Korff, M, Ciechanowski, P, Ludman, EJ, Young, BA (2007). Cost-effectiveness of systematic depression treatment among people with diabetes mellitus. Archives of General Psychiatry 64, 65–72.CrossRefGoogle ScholarPubMed
Simon, NM, Smoller, JW, McNamara, KL, Maser, RS, Zalta, AK, Pollack, MH, Nierenberg, AA, Fava, M, Wong, KK (2006). Telomere shortening and mood disorders: preliminary support for a chronic stress model of accelerated aging. Biological Psychiatry 60, 432–435.CrossRefGoogle ScholarPubMed
Steptoe, A, Hamer, M, Butcher, L, Lin, J, Brydon, L, Kivimaki, M, Marmot, M, Blackburn, E, Erusalimsky, JD (2011). Educational attainment but not measures of current socioeconomic circumstances are associated with leukocyte telomere length in healthy older men and women. Brain, Behavior, and Immunity 25, 1292–1298.CrossRefGoogle Scholar
Valdes, AM, Andrew, T, Gardner, JP, Kimura, M, Oelsner, E, Cherkas, LF, Aviv, A, Spector, TD (2005). Obesity, cigarette smoking, and telomere length in women. Lancet 366, 662–664.CrossRefGoogle ScholarPubMed
van Gool, CH, Kempen, GI, Penninx, BW, Deeg, DJ, Beekman, AT, van Eijk, JT (2003). Relationship between changes in depressive symptoms and unhealthy lifestyles in late middle aged and older persons: results from the Longitudinal Aging Study Amsterdam. Age and Ageing 32, 81–87.CrossRefGoogle ScholarPubMed
von Zglinicki, T (2002). Oxidative stress shortens telomeres. Trends in Biochemical Sciences 27, 339–344.CrossRefGoogle ScholarPubMed
Wikgren, M, Maripuu, M, Karlsson, T, Nordfjall, K, Bergdahl, J, Hultdin, J, Del-Favero, J, Roos, G, Nilsson, LG, Adolfsson, R, Norrback, KF (2012). Short telomeres in depression and the general population are associated with a hypocortisolemic state. Biological Psychiatry 71, 294–300.CrossRefGoogle ScholarPubMed
Wittchen, HU (1994). Reliability and validity studies of the WHO-Composite International Diagnostic Interview (CIDI): a critical review. Journal of Psychiatric Research 28, 57–84.CrossRefGoogle ScholarPubMed
Wittchen, HU, Burke, JD, Semler, G, Pfister, H, Von Cranach, M, Zaudig, M (1989). Recall and dating of psychiatric symptoms. Test-retest reliability of time-related symptom questions in a standardized psychiatric interview. Archives of General Psychiatry 46, 437–443.CrossRefGoogle Scholar
Wittchen, HU, Robins, LN, Cottler, LB, Sartorius, N, Burke, JD, Regier, D (1991). Cross-cultural feasibility, reliability and sources of variance of the Composite International Diagnostic Interview (CIDI). The Multicentre WHO/ADAMHA Field Trials. British Journal of Psychiatry 159, 645–653, 658.CrossRefGoogle ScholarPubMed
Wolkowitz, OM, Epel, ES, Reus, VI, Mellon, SH (2010). Depression gets old fast: do stress and depression accelerate cell aging? Depression and Anxiety 27, 327–338.CrossRefGoogle ScholarPubMed
Wolkowitz, OM, Mellon, SH, Epel, ES, Lin, J, Dhabhar, FS, Su, Y, Reus, VI, Rosser, R, Burke, HM, Kupferman, E, Compagnone, M, Nelson, JC, Blackburn, EH (2011). Leukocyte telomere length in major depression: correlations with chronicity, inflammation and oxidative stress – preliminary findings. PloS One 6, e17837.CrossRefGoogle ScholarPubMed
Wong, JM, Collins, K (2003). Telomere maintenance and disease. Lancet 362, 983–988.CrossRefGoogle ScholarPubMed
Yager, S, Forlenza, MJ, Miller, GE (2010). Depression and oxidative damage to lipids. Psychoneuroendocrinology 35, 1356–1362.CrossRefGoogle ScholarPubMed
Zhu, H, Belcher, M, van der Harst, P (2011). Healthy aging and disease: role for telomere biology? Clinical Science 120, 427–440.CrossRefGoogle ScholarPubMed