Mindfulness Center, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA.
Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Sci Rep. 2023 Feb 21;13(1):3055. doi: 10.1038/s41598-023-28660-7.
The identification of markers of mental health illness treatment response and susceptibility using personalized medicine has been elusive. In the context of psychological treatment for anxiety, we conducted two studies to identify psychological phenotypes with distinct characteristics related to: psychological intervention modalities (mindfulness training/awareness), mechanism of action (worry), and clinical outcome (generalized anxiety disorder scale scores). We also examined whether phenotype membership interacted with treatment response (Study 1) and mental health illness diagnosis (Studies 1-2). Interoceptive awareness, emotional reactivity, worry, and anxiety were assessed at baseline in treatment-seeking individuals (Study 1, n = 63) and from the general population (Study 2, n = 14,010). In Study 1, participants were randomly assigned to an app-delivered mindfulness program for anxiety for two months or treatment as usual. Changes in anxiety were assessed 1 and 2 months post-treatment initiation. In studies 1-2, three phenotypes were identified: 'severely anxious with body/emotional awareness' (cluster 1), 'body/emotionally unaware' (cluster 2), and 'non-reactive and aware' (cluster 3). Study 1's results revealed a significant treatment response relative to controls (ps < 0.001) for clusters 1 and 3, but not for cluster 2. Chi-square analyses revealed that phenotypes exhibited significantly different proportions of participants with mental health diagnoses (studies 1-2). These results suggest that psychological phenotyping can bring the application of personalized medicine into clinical settings.Registry name and URL: Developing a novel digital therapeutic for the treatment of generalized anxiety disorder https://clinicaltrials.gov/ct2/show/NCT03683472?term=judson+brewer&draw=1&rank=1 .Trial registration: Registered at clinicaltrials.gov (NCT03683472) on 25/09/2018.
使用个性化医学识别心理健康疾病治疗反应和易感性的标志物一直难以捉摸。在焦虑的心理治疗背景下，我们进行了两项研究，以确定具有不同特征的心理表型，这些特征与：心理干预方式（正念训练/意识）、作用机制（担忧）和临床结果（广泛性焦虑症量表评分）有关。我们还研究了表型成员是否与治疗反应（研究 1）和心理健康疾病诊断（研究 1-2）相互作用。在寻求治疗的个体（研究 1，n=63）和一般人群（研究 2，n=14010）中，在基线时评估了内感受意识、情绪反应、担忧和焦虑。在研究 1 中，参与者被随机分配到为期两个月的应用程序提供的焦虑正念治疗或常规治疗。在治疗开始后 1 和 2 个月评估焦虑的变化。在研究 1-2 中，确定了三种表型：“严重焦虑伴身体/情绪意识”（簇 1）、“身体/情绪无意识”（簇 2）和“无反应且有意识”（簇 3）。研究 1 的结果显示，与对照组相比，簇 1 和簇 3 有显著的治疗反应（p<0.001），但簇 2 没有。卡方分析显示，表型表现出不同比例的心理健康诊断参与者（研究 1-2）。这些结果表明，心理表型可以将个性化医学的应用带入临床环境。注册号和网址：为广泛性焦虑症开发一种新的数字治疗方法 https://clinicaltrials.gov/ct2/show/NCT03683472?term=judson+brewer&draw=1&rank=1.试验注册：于 2018 年 9 月 25 日在 clinicaltrials.gov 注册（NCT03683472）。
