Predicting Response Trajectories during Cognitive-Behavioural Therapy for Panic Disorder

Background: Anxiety disorders are highly prevalent and result in low quality of life and a high social and economic cost. The efficacy of cognitive-behavioural therapy (CBT) for anxiety disorders is well established, but a substantial proportion of patients do not respond to this treatment. Understa...

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Detalles Bibliográficos
Autores: Santacana, Martí, Arias, Barbara|||0000-0001-9181-2132, Mitjans, Marina, Bonillo Martín, Albert|||0000-0002-6141-9708, Montoro, María|||0000-0002-1807-7044, Rosado, Sílvia, Guillamat, Roser, Vallès, Vicenç|||0000-0003-3170-4353, Pérez Solà, Víctor|||0000-0002-5825-2337, Forero, Carlos G.|||0000-0002-5245-0076, Fullana, Miguel|||0000-0003-3863-5223
Tipo de recurso: artículo
Fecha de publicación:2016
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:170650
Acceso en línea:https://ddd.uab.cat/record/170650
https://dx.doi.org/urn:doi:10.1371/journal.pone.0158224
Access Level:acceso abierto
Palabra clave:Child abuse
Human genetics
Anxiety disorders
Drug therapy
Genetic polymorphism
Anxiety
Panic disorder
Epigenetics
Descripción
Sumario:Background: Anxiety disorders are highly prevalent and result in low quality of life and a high social and economic cost. The efficacy of cognitive-behavioural therapy (CBT) for anxiety disorders is well established, but a substantial proportion of patients do not respond to this treatment. Understanding which genetic and environmental factors are responsible for this differential response to treatment is a key step towards "personalized medicine". Based on previous research, our objective was to test whether the BDNF Val66Met polymorphism and/or childhood maltreatment are associated with response trajectories during exposure-based CBT for panic disorder (PD). Method: We used Growth Mixture Modeling to identify latent classes of change (response trajectories) in patients with PD (N = 97) who underwent group manualized exposure-based CBT. We conducted logistic regression to investigate the effect on these trajectories of the BDNF Val66Met polymorphism and two different types of childhood maltreatment, abuse and neglect. Results: We identified two response trajectories ("high response" and "low response"), and found that they were not significantly associated with either the genetic (BDNF Val66Met polymorphism) or childhood trauma-related variables of interest, nor with an interaction between these variables. Conclusions: We found no evidence to support an effect of the BDNF gene or childhood trauma-related variables on CBT outcome in PD. Future studies in this field may benefit from looking at other genotypes or using different (e.g. whole-genome) approaches.