Telomere length as a suicide probability marker

Telomere shortening has been shown to be a marker not only of cellular aging but also of a number of pathological processes and diseases, including suicidal behavior and the risk of completed suicide. The aim of this study was to summarize the association between telomere length and telomerase activity with mental disorders and suicidal tendencies. Methods. A targeted search of full-text publications in the PubMed database was carried out using the keyword combination: telomere length suicide, telomeres suicide, lithium telomeres suicide, depression telomeres suicide, schizophrenia telomeres. Results. An analysis of 65 full-text publications yielded compelling evidence of genetic differences between patients with schizophrenia, major depressive disorder, bipolar disorder, epilepsy, and mentally healthy individuals not prone to suicide, and individuals from the same clinical groups with suicidal behavior, including those resulting in completed suicide. It should be noted that significant telomere shortening caused by decreased activity of the catalytic component of telomerase reverse transcriptase (hTERT) and/or its RNA component (TERC) leads to impaired mitochondrial respiration with reduced ATP production, activation of mitochondria-dependent inflammatory processes, and pathologically accelerated apoptosis. This is the only marker that distinguishes individuals with mental disorders and suicidal tendencies from mentally ill individuals without suicidal tendencies, whose telomeres are comparable in length to those of healthy individuals or are slightly shortened. Long-term treatment with Li+ and, to a lesser extent, other antipsychotic drugs that prevent telomere shortening is most effective. Li+ even partially restores telomere length, including in healthy individuals with age-related telomere shortening. Conclusion. Telomeres in mentally ill individuals and healthy individuals prone to suicide are statistically significantly shorter than those in healthy individuals who are not prone to suicide and in patients with mental illness. Congenital and acquired telomere shortening can be used as an early marker of potential suicidal tendencies for the formation of target groups for suicide prevention and preclinical identification of individuals at potential risk for developing mental disorders. Long-term intake of Li+ prevents telomere shortening and reduces the risk of suicide by restoring reduced telomerase activity to values close to physiological ones.