Abstract
BackgroundAnxiety 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).MethodWe 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.ResultsWe 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.ConclusionsWe 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.
Highlights
The high prevalence of the anxiety disorders is a major public health concern
Our objective was to test whether the brain-derived neurotrophic factor (BDNF) Val66Met polymorphism and/or childhood maltreatment are associated with response trajectories during exposure-based cognitive-behavioural therapy (CBT) for panic disorder (PD)
We found no evidence to support an effect of the BDNF gene or childhood trauma-related variables on CBT outcome in PD
Summary
The high prevalence of the anxiety disorders is a major public health concern. Twelve-month prevalence rates have been estimated at 18.1% in the US [1] and 13.6% in Europe [2]. A substantial proportion of patients do not respond to this treatment [8], and identifying the factors underlying this differential treatment response is a research priority. In this context, genetic and environmental predictors of outcome have gained attention [9, 10] and will make a key contribution towards “personalized medicine” [11]. 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. 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)
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