Leukocyte telomere length and accelerated aging as predictors for the onset of psychosis
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Leukocyte telomere length is an emerging marker for pathologically accelerated cellular aging. First discovered to be associated with aging-related disorders, such as type 2 diabetes mellitus and cardiovascular disease, in young individuals, leukocyte telomeric degeneration is also garnering growing attention in psychiatric illnesses. Comorbid metabolic symptoms and physiological dysregulation observed in schizophrenia patients imply a plausible association between pathological telomere biology and psychosis. Available data on the relationship between leukocyte telomere length and schizophrenia is limited largely to small-sample, cross-sectional studies unable to fully account for the large body of potentially confounding factors on telomere length (psychotropic medication, chronic stress and history of trauma, comorbidities, paternal age, substance use, subject-level variables). The most comprehensive meta-analysis to date reveals a significant trend of shortened telomeres in schizophrenia patients as compared to healthy controls. Some findings suggest a linear relationship between telomeric attrition and disease chronicity/severity. However, overall findings are insufficient to gauge the potential of leukocyte telomere length as a predictive, diagnostic biomarker in this patient population. Future longitudinal studies with carefully controlled covariates are required to verify the promising potential of a new marker for schizophrenia onset and a possible new direction for adjunctive antipsychotic treatment.