Predicting Response Trajectories during Cognitive-Behavioural Therapy for Panic Disorder: No Association with the BDNF Gene or Childhood Maltreatment

• Published in: PloS one 2016-06, Vol.11 (6), p.e0158224
• Main Authors: Santacana, Martí, Arias, Bárbara, Mitjans, Marina, Bonillo, Albert, Montoro, María, Rosado, Sílvia, Guillamat, Roser, Vallès, Vicenç, Pérez, Víctor, Forero, Carlos G, Fullana, Miquel A
• Format: Article
• Language: English
• Subjects: Abuse; Adolescent; Adult; Ansietat; Anxiety; Biology and Life Sciences; Brain-derived neurotrophic factor; Brain-Derived Neurotrophic Factor - genetics; Care and treatment; Child Abuse; Children; Cognitive ability; Cognitive behavioral therapy; Cognitive Therapy; Complications and side effects; Disorders; Environmental factors; Exposure; Female; Gene polymorphism; Genetic polymorphisms; Genetic Variation; Genome, Human; Genomes; Genotype; Genotypes; Genètica humana; Human genetics; Humans; Male; Maltractament infantil; Medicine and Health Sciences; Middle Aged; Models, Statistical; Panic disorder; Panic Disorder - complications; Panic Disorder - therapy; Panic disorders; Patient outcomes; Patients; Polimorfisme genètic; Polymorphism; Polymorphism, Genetic; Precision medicine; Psychotherapy, Group; Quality of Life; Regression Analysis; Risk factors; Social Sciences; Therapy; Trajectories; Trastorns de pànic; Trauma; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0158224

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). 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. 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. 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.