Coleman Jonathan R I, Lester Kathryn J, Keers Robert, Roberts Susanna, Curtis Charles, Arendt Kristian, Bögels Susan, Cooper Peter, Creswell Cathy, Dalgleish Tim, Hartman Catharina A, Heiervang Einar R, Hötzel Katrin, Hudson Jennifer L, In-Albon Tina, Lavallee Kristen, Lyneham Heidi J, Marin Carla E, Meiser-Stedman Richard, Morris Talia, Nauta Maaike H, Rapee Ronald M, Schneider Silvia, Schneider Sophie C, Silverman Wendy K, Thastum Mikael, Thirlwall Kerstin, Waite Polly, Wergeland Gro Janne, Breen Gerome, Eley Thalia C
Jonathan R. I. Coleman, MSc, King's College London, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), MRC Social, Genetic and Developmental Psychiatry (SGDP) Centre, UK; Kathryn J. Lester, DPhil, King's College London, IoPPN, MRC SGDP Centre, UK, and School of Psychology, University of Sussex, UK; Robert Keers, PhD, Susanna Roberts, MSc, King's College London, IoPPN, MRC SGDP Centre, UK; Charles Curtis, MSc, King's College London, IoPPN, MRC SGDP Centre, UK, and National Institute for Health Research Biomedical Research Centre, South London and Maudsley National Health Service Trust, UK; Kristian Arendt, PhD, Department of Psychology and Behavioural Sciences, Aarhus University, Denmark; Susan Bögels, PhD, Research Institute Child Development and Education, University of Amsterdam, The Netherlands; Peter Cooper, DPhil, School of Psychology and Clinical Language Sciences, University of Reading, UK, and Department of Psychology, Stellenbosch University, South Africa; Cathy Creswell, DClinPsy, PhD, School of Psychology and Clinical Language Sciences, University of Reading, UK; Tim Dalgleish, PhD, MRC Cognition & Brain Sciences Unit, Cambridge, UK; Catharina A. Hartman, PhD, Department of Psychiatry, University of Groningen, University Medical Center Groningen, The Netherlands; Einar R. Heiervang, PhD, Institute of Clinical Medicine, University of Oslo, Norway; Katrin Hötzel, PhD, Department of Psychology, Ruhr-Universität Bochum, Germany; Jennifer L. Hudson, PhD, Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia; Tina In-Albon, PhD, Clinical Child and Adolescent Psychology, Universität Koblenz-Landau, Germany; Kristen Lavallee, PhD, Department of Psychology, University of Basel, Switzerland; Heidi J. Lyneham, PhD, Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia; Carla E. Marin, PhD, Yale University, Child Study Center, New Haven, Connecticut, USA; Richard Meiser-S
Br J Psychiatry. 2016 Sep;209(3):236-43. doi: 10.1192/bjp.bp.115.168229. Epub 2016 Mar 17.
Anxiety disorders are common, and cognitive-behavioural therapy (CBT) is a first-line treatment. Candidate gene studies have suggested a genetic basis to treatment response, but findings have been inconsistent.
To perform the first genome-wide association study (GWAS) of psychological treatment response in children with anxiety disorders (n = 980).
Presence and severity of anxiety was assessed using semi-structured interview at baseline, on completion of treatment (post-treatment), and 3 to 12 months after treatment completion (follow-up). DNA was genotyped using the Illumina Human Core Exome-12v1.0 array. Linear mixed models were used to test associations between genetic variants and response (change in symptom severity) immediately post-treatment and at 6-month follow-up.
No variants passed a genome-wide significance threshold (P = 5 × 10(-8)) in either analysis. Four variants met criteria for suggestive significance (P<5 × 10(-6)) in association with response post-treatment, and three variants in the 6-month follow-up analysis.
This is the first genome-wide therapygenetic study. It suggests no common variants of very high effect underlie response to CBT. Future investigations should maximise power to detect single-variant and polygenic effects by using larger, more homogeneous cohorts.
焦虑症很常见,认知行为疗法(CBT)是一线治疗方法。候选基因研究表明治疗反应存在遗传基础,但研究结果并不一致。
对焦虑症儿童(n = 980)的心理治疗反应进行首次全基因组关联研究(GWAS)。
在基线、治疗结束时(治疗后)以及治疗结束后3至12个月(随访),通过半结构化访谈评估焦虑的存在情况和严重程度。使用Illumina Human Core Exome - 12v1.0芯片对DNA进行基因分型。采用线性混合模型测试基因变异与治疗后即刻及6个月随访时的反应(症状严重程度变化)之间的关联。
在两项分析中,均无变异达到全基因组显著性阈值(P = 5×10⁻⁸)。四个变异在与治疗后反应的关联中达到提示性显著性标准(P<5×10⁻⁶),在6个月随访分析中有三个变异达到该标准。
这是首次全基因组治疗遗传学研究。研究表明,CBT反应背后不存在具有非常高效应的常见变异。未来的研究应通过使用更大、更同质的队列,最大限度地提高检测单变异和多基因效应的能力。