Dr Thalia Eley

The Think-Tank seminar series

Therapygenetics: Using genetic information to predict psychological treatment response

Facilitator

Dr Thalia Eley, Reader in Developmental Behavioural Genetics: MRC Social, Genetic and Developmental Psychiatry Centre

Date and time

12:00 - 1:00pm, 27 September 2012

Abstract

Background

Child anxiety disorder is a chronic debilitating condition. Cognitive Behavioural Therapy (CBT) is successful in approximately 60% of cases, with poor response associated with greater severity, comorbidity and parental psychopathology, implicating genetic influence. The twin literature has shown that genetic influences interact with both negative and positive environmental influences, thus genes may predispose individuals to respond well or poorly to a psychological treatment. The Serotonin Transporter Promoter Polymorphism (5HTTLPR) has been associated with responsivity to the environment. Specifically, the short (S) allele has been associated with increased depression in the presence of stress, and with better outcomes in the absence of stress, and may thus be a marker of environmental responsivity. The nerve growth factor rs6330 polymorphism (NGF rs6330) has been associated with anxiety and is implicated in synaptic plasticity and response to stress.  Methods. We examined the role of the 5HTTLPR and NGF genotypes in predicting anxiety diagnosis and response to CBT in child anxiety disorders, using a gene-environment interaction approach. Children aged 6-13 years with a primary diagnosis of anxiety disorder undergoing CBT provided DNA (N = 559, 357 from white European ancestry).

Results

There was an association between both genetic markers and treatment response at follow-up. Those with the 5HTTLPR SS genotype were 20% more likely than the SL/LL group, to be free of their primary or all anxiety diagnoses by follow-up. Those with the NGF TT genotype were 24% more likely to remit than those with the CC genotype. These associations were independent of significant influences of pre-treatment symptom severity, and comorbid mood disorder on treatment response.

Discussion

If replicated, these findings suggest that in time it could be possible to predict which children are least likely to benefit from CBT alone and would benefit from an enhanced treatment package.