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Bai P. Application and Mechanisms of Internet-Based Cognitive Behavioral Therapy (iCBT) in Improving Psychological State in Cancer Patients. J Cancer 2023; 14:1981-2000. [PMID: 37497400 PMCID: PMC10367931 DOI: 10.7150/jca.82632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 04/18/2023] [Indexed: 07/28/2023] Open
Abstract
This review article is an overview of the effectiveness of internet-based cognitive behavioral therapy (iCBT) in Improving Psychological State in Cancer Patients. iCBT's effectiveness has been investigated in treating and managing conditions like depression, psychiatric disorders, generalized anxiety disorder (GAD), panic disorder, obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), adjustment disorder, bipolar disorder, chronic pain, and phobias. iCBT's role in the treatment of medical conditions such as diabetes mellitus with comorbid psychiatric illnesses was also explored. We conducted a thorough literature search using PubMed, Embase, Google Scholar, and Wanfang with no restrictions on the date. iCBT's role in treating and controlling psychiatric illnesses in cancer patients has been established in the literature. Development and popularization of iCBT, treament forms of iCBT, platforms for iCBT, application of iCBT, strategies and efficacy of iCBT for insomnia in cancer patients, current status of iCBT application, and genetic researches on iCBT for anxiety disorders were all reviewed and discussed in this review. From the data compiled, we conclude that iCBT is useful in treating or improving psychological state in cancer patients.
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Affiliation(s)
- Ping Bai
- Department of Operating Rooms, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
- Department of Operating Rooms, National Cancer Center/National Clinical Research Center for Cancer/Hebei Cancer Hospital, Chinese Academy of Medical Sciences, Langfang, 065001, China
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Abstract
Anxiety disorders are among the most common psychiatric disorders worldwide. They often onset early in life, with symptoms and consequences that can persist for decades. This makes anxiety disorders some of the most debilitating and costly disorders of our time. Although much is known about the synaptic and circuit mechanisms of fear and anxiety, research on the underlying genetics has lagged behind that of other psychiatric disorders. However, alongside the formation of the Psychiatric Genomic Consortium Anxiety workgroup, progress is rapidly advancing, offering opportunities for future research.Here we review current knowledge about the genetics of anxiety across the lifespan from genetically informative designs (i.e. twin studies and molecular genetics). We include studies of specific anxiety disorders (e.g. panic disorder, generalised anxiety disorder) as well as those using dimensional measures of trait anxiety. We particularly address findings from large-scale genome-wide association studies and show how such discoveries may provide opportunities for translation into improved or new therapeutics for affected individuals. Finally, we describe how discoveries in anxiety genetics open the door to numerous new research possibilities, such as the investigation of specific gene-environment interactions and the disentangling of causal associations with related traits and disorders.We discuss how the field of anxiety genetics is expected to move forward. In addition to the obvious need for larger sample sizes in genome-wide studies, we highlight the need for studies among young people, focusing on specific underlying dimensional traits or components of anxiety.
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Affiliation(s)
- Helga Ask
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Rosa Cheesman
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Eshim S Jami
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London, UK
| | - Daniel F Levey
- Division of Human Genetics, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
- Department of Psychiatry, Veterans Affairs Connecticut Healthcare Center, West Haven, Connecticut
| | - Kirstin L Purves
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Heike Weber
- Department of Psychology, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
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Mufford MS, van der Meer D, Andreassen OA, Ramesar R, Stein DJ, Dalvie S. A review of systems biology research of anxiety disorders. ACTA ACUST UNITED AC 2021; 43:414-423. [PMID: 33053074 PMCID: PMC8352731 DOI: 10.1590/1516-4446-2020-1090] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 06/24/2020] [Indexed: 01/04/2023]
Abstract
The development of "omic" technologies and deep phenotyping may facilitate a systems biology approach to understanding anxiety disorders. Systems biology approaches incorporate data from multiple modalities (e.g., genomic, neuroimaging) with functional analyses (e.g., animal and tissue culture models) and mathematical modeling (e.g., machine learning) to investigate pathological biophysical networks at various scales. Here we review: i) the neurobiology of anxiety disorders; ii) how systems biology approaches have advanced this work; and iii) the clinical implications and future directions of this research. Systems biology approaches have provided an improved functional understanding of candidate biomarkers and have suggested future potential for refining the diagnosis, prognosis, and treatment of anxiety disorders. The systems biology approach for anxiety disorders is, however, in its infancy and in some instances is characterized by insufficient power and replication. The studies reviewed here represent important steps to further untangling the pathophysiology of anxiety disorders.
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Affiliation(s)
- Mary S Mufford
- South African Medical Research Council Genomic and Precision Medicine Research Unit, Division of Human Genetics, Institute of Infectious Disease and Molecular Medicine, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Dennis van der Meer
- Division of Mental Health and Addiction, Norwegian Centre for Mental Disorders Research (NORMENT), Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,School of Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Ole A Andreassen
- Division of Mental Health and Addiction, Norwegian Centre for Mental Disorders Research (NORMENT), Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Raj Ramesar
- South African Medical Research Council Genomic and Precision Medicine Research Unit, Division of Human Genetics, Institute of Infectious Disease and Molecular Medicine, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Dan J Stein
- South African Medical Research Council (SAMRC), Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Shareefa Dalvie
- South African Medical Research Council (SAMRC), Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
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Rodriguez N, Martinez-Pinteño A, Blázquez A, Ortiz AE, Moreno E, Gassó P, Lafuente A, Lazaro L, Mas S. Integrative DNA Methylation and Gene Expression Analysis of Cognitive Behavioral Therapy Response in Children and Adolescents with Obsessive-Compulsive Disorder; a Pilot Study. Pharmgenomics Pers Med 2021; 14:757-766. [PMID: 34234515 PMCID: PMC8254600 DOI: 10.2147/pgpm.s313015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/05/2021] [Indexed: 11/28/2022]
Abstract
Purpose Here, we propose an integrative analysis of genome-wide methylation and gene expression to provide new insight into the biological mechanisms of Cognitive behavioral therapy (CBT) in pediatric obsessive-compulsive disorder (OCD). Patients and Methods Twelve children and adolescents with OCD receiving CBT for the first time were classified as responders or non-responders after eight weeks of CBT. Differentially methylated positions (DMPs) and gene co-expression modules were identified using specific R software packages. Correlations between the DMPs and gene co-expression modules were investigated. Results Two genes were enriched with significant DMPs (Δβ > ± 0.2, FDR-adjusted p-value < 0.05): PIWIL1 and MIR886. The yellowgreen module of co-expressed genes was associated with CBT response (FDR-adjusted p-value = 0.0003). Significant correlations were observed between the yellowgreen module and the CpGs in PIWIL1 and MIR886 (p < 0.008). Patients showing hypermethylation in these CpGs presented an upregulation in the genes in the yellowgreen module. Conclusion Taken together, the preliminary results of this systems-level approach, despite the study limitations, provide evidence that the epigenetic regulation of ncRNAs could be a predictor of CBT response. Limitations The sample size limited the statistical power, and given that the study was hypothesis-driven, our results should be seen as preliminary.
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Affiliation(s)
- Natalia Rodriguez
- Department of Basic Clinical Practice, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Albert Martinez-Pinteño
- Department of Basic Clinical Practice, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Ana Blázquez
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic de Barcelona, Barcelona, Spain.,Clinical and Experimental Neuroscience Area, The August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Ana Encarnación Ortiz
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic de Barcelona, Barcelona, Spain.,Clinical and Experimental Neuroscience Area, The August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Elena Moreno
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Patricia Gassó
- Department of Basic Clinical Practice, Pharmacology Unit, University of Barcelona, Barcelona, Spain.,Clinical and Experimental Neuroscience Area, The August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Amalia Lafuente
- Department of Basic Clinical Practice, Pharmacology Unit, University of Barcelona, Barcelona, Spain.,Clinical and Experimental Neuroscience Area, The August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.,G04 Group, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain
| | - Luisa Lazaro
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic de Barcelona, Barcelona, Spain.,Clinical and Experimental Neuroscience Area, The August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.,G04 Group, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Sergi Mas
- Department of Basic Clinical Practice, Pharmacology Unit, University of Barcelona, Barcelona, Spain.,Clinical and Experimental Neuroscience Area, The August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.,G04 Group, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain
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Liu HK, He SJ, Zhang JG. A bioinformatic study revealed serotonergic neurons are involved in the etiology and therapygenetics of anxiety disorders. Transl Psychiatry 2021; 11:297. [PMID: 34011923 PMCID: PMC8134630 DOI: 10.1038/s41398-021-01432-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/26/2021] [Accepted: 05/05/2021] [Indexed: 12/13/2022] Open
Abstract
Genetic factors contribute to the susceptibility of anxiety disorders (ADs) and responses to associated cognitive-behavioral therapy (CBT). However, the type of brain cell affected by the related genes remains unclear. Previous studies have indicated various important brain neurons associated with psychiatric disorders, highlighting the necessity to study the cellular basis of anxiety. We assembled 37 AD-related genes and 23 CBT-related genes from recent large-scale genome-wide association studies, and then investigated their cell-type specificity in single-cell transcriptome data via an expression weighted cell type enrichment method. Additionally, to investigate the cellular differences between ADs and other psychiatric disorders, we excluded the genes associated with major depressive disorder, bipolar disorder, and neuroticism, resulting in 29 AD-specific genes. Remarkably, results indicate that serotonergic neurons are significantly associated with both AD-related and CBT-related genes, despite the two gene sets showing no overlap. These observations provide evidence that serotonergic neurons are involved in the etiology and therapygenetics of ADs. Moreover, results also showed that serotonergic neurons are associated with AD-specific genes, providing a supplementary finding that is in opposition to previous studies that found no evidence for the association between serotonergic neurons and psychiatric disorders via the same strategy. In summary, the current study found that serotonergic neurons are involved in the etiology and therapygenetics of ADs, providing insights into their genetic and cellular basis. Further, this cellular difference study may deepen our understanding of ADs and other psychiatric disorders.
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Affiliation(s)
- Han-Kui Liu
- grid.21155.320000 0001 2034 1839BGI-Shenzhen, Shenzhen, China
| | - Si-Jie He
- Shijiazhuang BGI Genomics Co., Ltd, Shijiazhuang, China
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Margraf J, Hoyer J, Fydrich T, In-albon T, Lincoln T, Lutz W, Schlarb A, Schöttke H, Willutzki U, Velten J. The cooperative revolution reaches clinical psychology and psychotherapy: An example from Germany. Clin Psychol Eur 2021; 3:e4459. [PMID: 36397785 PMCID: PMC9667120 DOI: 10.32872/cpe.4459] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 12/30/2020] [Indexed: 01/20/2023] Open
Abstract
Background Psychology is at the beginning of a cooperative revolution. Traditionally,
psychological research has been conducted by individual labs, limiting its
scope in clinical samples and promoting replication problems. Large-scale
collaborations create new opportunities for highly powered studies in this
resource-intensive research area. To present the current state of a
Germany-wide platform for coordinating research across university outpatient
clinics for psychotherapy. Method Since 1999, over 50 such clinics were created in Germany. They represent a
unique infrastructure for research, training, and clinical care. In 2013, a
steering committee initiated a nationwide research platform for systematic
coordination of research in these clinics (German abbreviation “KODAP”). Its
main goal is to aggregate and analyze longitudinal treatment data –
including patient, therapist, and treatment characteristics – across all
participating clinics. Results An initial survey (100% response rate) yielded recommendations for improved
integration of data collection. Pilot data from 4,504 adult (16 clinics) and
568 child and adolescent patients (7 clinics) proved feasibility of data
transfer and aggregation despite different data formats. Affective,
neurotic, stress, and somatoform (adults) and anxiety and behavioral
(children and adolescents) disorders were most frequent; comorbidity was
high. Overcoming legal, methodological, and technical challenges, a common
core assessment battery was developed, and data collection started in 2018.
To date, 42 clinics have joined. Conclusions KODAP shows that research collaboration across university outpatient clinics
is feasible. Fulfilling the need for stronger cumulative and cooperative
research in Clinical Psychology will contribute to better knowledge about
mental health, a core challenge to modern societies. Data from 4,504 adult and 568 child and adolescent patients were
successfully aggregated across 23 outpatient clinics. Affective, neurotic, stress, and somatoform (adults) and anxiety and
behavioral (children and adolescents) disorders were most frequent;
comorbidity was high. Legal, methodological, and technical challenges were overcome, and a
common core assessment battery was developed. 42 clinics have joined a Germany-wide research platform for
systematic coordination of research in these clinics. Longitudinal
data collection started in 2018.
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Schwarzmeier H, Leehr EJ, Böhnlein J, Seeger FR, Roesmann K, Gathmann B, Herrmann MJ, Siminski N, Junghöfer M, Straube T, Grotegerd D, Dannlowski U. Theranostic markers for personalized therapy of spider phobia: Methods of a bicentric external cross-validation machine learning approach. Int J Methods Psychiatr Res 2020; 29:e1812. [PMID: 31814209 PMCID: PMC7301283 DOI: 10.1002/mpr.1812] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 09/18/2019] [Accepted: 10/08/2019] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Embedded in the Collaborative Research Center "Fear, Anxiety, Anxiety Disorders" (CRC-TRR58), this bicentric clinical study aims at identifying biobehavioral markers of treatment (non-)response by applying machine learning methodology with an external cross-validation protocol. We hypothesize that a priori prediction of treatment (non-)response is possible in a second, independent sample based on multimodal markers. METHODS One-session virtual reality exposure treatment (VRET) with patients with spider phobia was conducted on two sites. Clinical, neuroimaging, and genetic data were assessed at baseline, post-treatment and after 6 months. The primary and secondary outcomes defining treatment response are as follows: 30% reduction regarding the individual score in the Spider Phobia Questionnaire and 50% reduction regarding the individual distance in the behavioral avoidance test. RESULTS N = 204 patients have been included (n = 100 in Würzburg, n = 104 in Münster). Sample characteristics for both sites are comparable. DISCUSSION This study will offer cross-validated theranostic markers for predicting the individual success of exposure-based therapy. Findings will support clinical decision-making on personalized therapy, bridge the gap between basic and clinical research, and bring stratified therapy into reach. The study is registered at ClinicalTrials.gov (ID: NCT03208400).
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Affiliation(s)
- Hanna Schwarzmeier
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center for Mental HealthUniversity Hospital of WürzburgWürzburgGermany
| | | | - Joscha Böhnlein
- Department of Psychiatry and PsychotherapyUniversity of MünsterMünsterGermany
| | - Fabian Reinhard Seeger
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center for Mental HealthUniversity Hospital of WürzburgWürzburgGermany
| | - Kati Roesmann
- Institute for Biomagnetism and BiosignalanalysisUniversity of MünsterMünsterGermany
- Otto‐Creutzfeld Center for Cognitive and Behavioral NeuroscienceUniversity of MünsterMünsterGermany
| | - Bettina Gathmann
- Institute of Medical Psychology and Systems NeuroscienceUniversity of MünsterMünsterGermany
| | - Martin J. Herrmann
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center for Mental HealthUniversity Hospital of WürzburgWürzburgGermany
| | - Niklas Siminski
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center for Mental HealthUniversity Hospital of WürzburgWürzburgGermany
| | - Markus Junghöfer
- Institute for Biomagnetism and BiosignalanalysisUniversity of MünsterMünsterGermany
- Otto‐Creutzfeld Center for Cognitive and Behavioral NeuroscienceUniversity of MünsterMünsterGermany
| | - Thomas Straube
- Institute of Medical Psychology and Systems NeuroscienceUniversity of MünsterMünsterGermany
- Otto‐Creutzfeld Center for Cognitive and Behavioral NeuroscienceUniversity of MünsterMünsterGermany
| | - Dominik Grotegerd
- Department of Psychiatry and PsychotherapyUniversity of MünsterMünsterGermany
| | - Udo Dannlowski
- Department of Psychiatry and PsychotherapyUniversity of MünsterMünsterGermany
- Otto‐Creutzfeld Center for Cognitive and Behavioral NeuroscienceUniversity of MünsterMünsterGermany
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Totzeck C, Teismann T, Hofmann SG, von Brachel R, Zhang XC, Wannemüller A, Pflug V, Margraf J. Affective Styles in Panic Disorder and Specific Phobia: Changes Through Cognitive Behavior Therapy and Prediction of Remission. Behav Ther 2020; 51:375-385. [PMID: 32402254 DOI: 10.1016/j.beth.2019.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 06/05/2019] [Accepted: 06/16/2019] [Indexed: 10/26/2022]
Abstract
Affective styles appear to be relevant to the development of psychopathology, especially anxiety disorders. The aim of the current study was to investigate changes in affective styles in patients with panic disorder and specific phobia, as a result of undergoing cognitive-behavioral therapy, and to identify a possible link between certain affective styles and remission. The sample consisted of outpatients (N = 101) suffering from panic disorder, specific phobia, or agoraphobia who completed the Affective Style Questionnaire (ASQ) before and after therapy, as well as at a 6-month follow-up assessment. Multivariate analyses of variance were conducted to test for changes due to therapy. Logistic regression analyses were calculated to test for the impact of affective styles on remission from anxiety disorders, and hierarchical regression analyses were calculated to examine the association between changes in affective styles and symptom reduction. Results indicated significant increases on the ASQ subscales adjusting and tolerating after therapy. Concealing did not decrease significantly after therapy. In addition, higher scores on adjusting significantly predicted remission from anxiety disorders. Finally, we found a significant association between increases on the adjusting scale and the reduction of anxiety symptoms.
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Min W, Zhou B, Huang Y, Wang J, Li Z, He Y, Zou Z, Sun X. A panel of miRNAs is involved in the effect of sertraline on panic disorder, as implicated by a microarray-based analysis. J Affect Disord 2019; 252:32-38. [PMID: 30974330 DOI: 10.1016/j.jad.2019.03.080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 02/18/2019] [Accepted: 03/25/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND MiRNAs are considered to be significant contributors to the pathogenesis of psychiatric diseases, but little is known about the potential roles of miRNAs in the treatment effect of panic disorder (PD). Therefore, we aimed to identify the miRNAs association with PD over the course of sertraline treatment. METHODS Sixty-seven patients were collected for a 6-week period of sertraline treatment, and evaluated using HAMD-17, HAMA-14 and PDSS both at the baseline and 6 weeks later. Blood samples were collected before and after treatment, respectively. Ten pairs of samples were analyzed using miRNA array, and the differentially expressed miRNAs were further validated using RT-PCR in the whole sample. RESULTS miR-451a, miR-144-5p, miR-25-3p and miR-660-5p were found to be significantly up-regulated, while miR-1 and miR-148-5p significantly down-regulated after sertraline treatment. The change of miR-25-3p before and after treatment (△miR-25-3p) was positively related to both the changes of PDSS3 scores (△PDSS3) (p = 0.017, 31.5% contribution) and △ PDSS7 (p = 0.016, 32.3% contribution). The △miR-660-5p was positively related to both the △HAMA5 (p = 0.03, 26% contribution) and △PDSS7 (p = 0.032). The △miR-148-5p was positively related to the △PDSS4 (p = 0.046, 21.5% contribution), but negatively related to the △HAMA13 (p = 0.005, 41.9% contribution). The △miR-144-5p was negatively related to the △HAMA9 (p = 0.032, 25.3% contribution). CONCLUSIONS These findings might provide some evidences to the involvement of miRNA in the effect of anti-anxiety agents, which contributed to the better understanding the disease and developing new therapeutic genetic targets.
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Affiliation(s)
- Wenjiao Min
- Mental Health Center, West China University Hospital, Sichuan University, Chengdu 610041, People's Republic of China; Psychosomatic department, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, Chengdu 610072, People's Republic of China
| | - Bo Zhou
- Psychosomatic department, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, Chengdu 610072, People's Republic of China
| | - Yulan Huang
- Psychosomatic department, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, Chengdu 610072, People's Republic of China
| | - Jinyu Wang
- Psychosomatic department, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, Chengdu 610072, People's Republic of China
| | - Zhengyu Li
- West China Second University Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Ying He
- Psychosomatic department, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, Chengdu 610072, People's Republic of China
| | - Zhili Zou
- Psychosomatic department, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, Chengdu 610072, People's Republic of China
| | - Xueli Sun
- Mental Health Center, West China University Hospital, Sichuan University, Chengdu 610041, People's Republic of China.
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Roberts S, Keers R, Breen G, Coleman JRI, Jöhren P, Kepa A, Lester KJ, Margraf J, Scheider S, Teismann T, Wannemüller A, Eley TC, Wong CCY. DNA methylation of FKBP5 and response to exposure-based psychological therapy. Am J Med Genet B Neuropsychiatr Genet 2019; 180:150-158. [PMID: 30334356 PMCID: PMC6600698 DOI: 10.1002/ajmg.b.32650] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 03/22/2018] [Accepted: 05/15/2018] [Indexed: 11/06/2022]
Abstract
Differential DNA methylation of the hypothalamic-pituitary-adrenal axis related gene FKBP5 has recently been shown to be associated with varying response to environmental influences and may play a role in how well people respond to psychological treatments. Participants (n = 111) received exposure-based cognitive behavioural therapy (CBT) for agoraphobia with or without panic disorder, or specific phobias. Percentage DNA methylation levels were measured for the promoter region and intron 7 of FKBP5. The association between percentage reduction in clinical severity and change in DNA methylation was tested using linear mixed models. The effect of genotype (rs1360780) was tested by the inclusion of an interaction term. The association between change in DNA methylation and FKBP5 expression was examined. Change in percentage DNA methylation at one CpG site of intron 7 was associated with percentage reduction in severity (β = -4.26, p = 3.90 × 10-4 ), where a decrease in DNA methylation was associated with greater response to therapy. An interaction was detected between rs1360780 and changes in DNA methylation in the promoter region of FKBP5 on treatment outcome (p = .045) but did not survive correction for multiple testing. Changes in DNA methylation were not associated with FKBP5 expression. Decreasing DNA methylation at one CpG site of intron 7 of FKBP5 was strongly associated with decreasing anxiety severity following exposure-based CBT. In addition, there was suggestive evidence that allele-specific methylation at the promoter region may also be associated with treatment response. The results of this study add to the growing literature demonstrating the role of biological processes such as DNA methylation in response to environmental influences.
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Affiliation(s)
- Susanna Roberts
- King's College London, Social, Genetic and Developmental Psychiatry CentreInstitute of Psychiatry, Psychology and NeuroscienceLondonUnited Kingdom
| | - Robert Keers
- King's College London, Social, Genetic and Developmental Psychiatry CentreInstitute of Psychiatry, Psychology and NeuroscienceLondonUnited Kingdom,Queen Mary University of LondonSchool of Biological and Chemical SciencesLondonUnited Kingdom
| | - Gerome Breen
- King's College London, Social, Genetic and Developmental Psychiatry CentreInstitute of Psychiatry, Psychology and NeuroscienceLondonUnited Kingdom,National Institute for Health Research Biomedical Research CentreSouth London and Maudsley National Health Service TrustUnited Kingdom
| | - Jonathan R. I. Coleman
- King's College London, Social, Genetic and Developmental Psychiatry CentreInstitute of Psychiatry, Psychology and NeuroscienceLondonUnited Kingdom
| | | | - Agnieszka Kepa
- King's College London, Social, Genetic and Developmental Psychiatry CentreInstitute of Psychiatry, Psychology and NeuroscienceLondonUnited Kingdom
| | - Kathryn J. Lester
- King's College London, Social, Genetic and Developmental Psychiatry CentreInstitute of Psychiatry, Psychology and NeuroscienceLondonUnited Kingdom,University of SussexDepartment of PsychologyBrightonUnited Kingdom
| | - Jürgen Margraf
- Ruhr‐Universität BochumMental Health Research and Treatment CenterBochumGermany
| | - Silvia Scheider
- Ruhr‐Universität BochumMental Health Research and Treatment CenterBochumGermany
| | - Tobias Teismann
- Ruhr‐Universität BochumMental Health Research and Treatment CenterBochumGermany
| | - André Wannemüller
- Ruhr‐Universität BochumMental Health Research and Treatment CenterBochumGermany
| | - Thalia C. Eley
- King's College London, Social, Genetic and Developmental Psychiatry CentreInstitute of Psychiatry, Psychology and NeuroscienceLondonUnited Kingdom
| | - Chloe C. Y. Wong
- King's College London, Social, Genetic and Developmental Psychiatry CentreInstitute of Psychiatry, Psychology and NeuroscienceLondonUnited Kingdom
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Andersson E, Crowley JJ, Lindefors N, Ljótsson B, Hedman-Lagerlöf E, Boberg J, El Alaoui S, Karlsson R, Lu Y, Mattheisen M, Kähler AK, Svanborg C, Mataix-Cols D, Mattsson S, Forsell E, Kaldo V, Schalling M, Lavebratt C, Sullivan PF, Rück C. Genetics of response to cognitive behavior therapy in adults with major depression: a preliminary report. Mol Psychiatry 2019; 24:484-90. [PMID: 30410065 DOI: 10.1038/s41380-018-0289-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Major depressive disorder is heritable and a leading cause of disability. Cognitive behavior therapy is an effective treatment for major depression. By quantifying genetic risk scores based on common genetic variants, the aim of this report was to explore the utility of psychiatric and cognitive trait genetic risk scores, for predicting the response of 894 adults with major depressive disorder to cognitive behavior therapy. The participants were recruited in a psychiatric setting, and the primary outcome score was measured using the Montgomery Åsberg Depression Rating Scale-Self Rated. Single-nucleotide polymorphism genotyping arrays were used to calculate the genomic risk scores based on large genetic studies of six phenotypes: major depressive disorder, bipolar disorder, attention-deficit/hyperactivity disorder, autism spectrum disorder, intelligence, and educational attainment. Linear mixed-effect models were used to test the relationships between the six genetic risk scores and cognitive behavior therapy outcome. Our analyses yielded one significant interaction effect (B = 0.09, p < 0.001): the autism spectrum disorder genetic risk score correlated with Montgomery Åsberg Depression Rating Scale-Self Rated changes during treatment, and the higher the autism spectrum disorder genetic load, the less the depressive symptoms decreased over time. The genetic risk scores for the other psychiatric and cognitive traits were not related to depressive symptom severity or change over time. Our preliminary results indicated, as expected, that the genomics of the response of patients with major depression to cognitive behavior therapy were complex and that future efforts should aim to maximize sample size and limit subject heterogeneity in order to gain a better understanding of the use of genetic risk factors to predict treatment outcome.
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Deckert J, Erhardt A. Predicting treatment outcome for anxiety disorders with or without comorbid depression using clinical, imaging and (epi)genetic data. Curr Opin Psychiatry 2019; 32:1-6. [PMID: 30480619 DOI: 10.1097/YCO.0000000000000468] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE OF REVIEW The present review complements previous reviews on prediction research in anxiety disorders with a focus on clinical, imaging and genetic as well as epigenetic factors and aims to provide recommendations for the design of future integrative studies in adults as well as children. RECENT FINDINGS Clinical factors predicting worse outcome such as a diagnosis of social anxiety disorder, comorbid depression and certain cognitive, behavioral and personality traits as well as low socioeconomic status were confirmed in large clinical studies. Imaging factors focusing on the fear and anxiety network were repeatedly described as predicting therapy response in small exploratory studies. The plethora of candidate gene studies has now been complemented by large genome-wide association studies and small epigenetic investigations with the need for replication in larger samples. SUMMARY The present status of research on predictors for therapy response in anxiety disorders, in particular on imaging and genetic factors, is still fragmentary. Some clinical factors for poorer outcome, though, have been consistently replicated and should be considered in the revision of therapy guidelines. There is a definite need for large integrative studies at the national and international level integrating multiple levels of biomarkers at different stages of development.
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Teismann T, Brailovskaia J, Totzeck C, Wannemüller A, Margraf J. Predictors of remission from panic disorder, agoraphobia and specific phobia in outpatients receiving exposure therapy: The importance of positive mental health. Behav Res Ther 2018; 108:40-44. [PMID: 29981937 DOI: 10.1016/j.brat.2018.06.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 05/30/2018] [Accepted: 06/21/2018] [Indexed: 10/28/2022]
Abstract
Positive mental health has been shown to predict remission from anxiety disorders in community samples. However, it is unclear, whether positive mental health is also predictive of symptom severity and remission from anxiety disorders in patients receiving exposure therapy. A total of 130 adult outpatients suffering from panic disorder, agoraphobia, or specific phobia received manualized exposure-therapy. Positive mental health was considered as a predictor of symptom severity and remission at the post-treatment assessment and at the follow-up assessment six months after treatment termination - controlling for depression, anxiety, anxiety cognitions, bodily sensations, number of treatment sessions, age and gender. Pre-treatment positive mental health was the only predictor of post-treatment symptom severity and remission status. Post-treatment positive mental health and avoidance behavior predicted symptom severity and remission status at the follow-up assessment. In conclusion, the current study highlights the importance of positive mental health in understanding remission from anxiety disorders.
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Affiliation(s)
- Tobias Teismann
- Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Germany.
| | - Julia Brailovskaia
- Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Germany
| | - Christina Totzeck
- Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Germany
| | - Andre Wannemüller
- Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Germany
| | - Jürgen Margraf
- Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Germany
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Lester KJ, Coleman JRI, Roberts S, Keers R, Breen G, Bögels S, Creswell C, Hudson JL, McKinnon A, Nauta M, Rapee RM, Schneider S, Silverman WK, Thastum M, Waite P, Wergeland GJH, Eley TC. Genetic variation in the endocannabinoid system and response to Cognitive Behavior Therapy for child anxiety disorders. Am J Med Genet B Neuropsychiatr Genet 2017; 174:144-155. [PMID: 27346075 PMCID: PMC5324578 DOI: 10.1002/ajmg.b.32467] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 05/25/2016] [Indexed: 01/31/2023]
Abstract
Extinction learning is an important mechanism in the successful psychological treatment of anxiety. Individual differences in response and relapse following Cognitive Behavior Therapy may in part be explained by variability in the ease with which fears are extinguished or the vulnerability of these fears to re-emerge. Given the role of the endocannabinoid system in fear extinction, this study investigates whether genetic variation in the endocannabinoid system explains individual differences in response to CBT. Children (N = 1,309) with a primary anxiety disorder diagnosis were recruited. We investigated the relationship between variation in the CNR1, CNR2, and FAAH genes and change in primary anxiety disorder severity between pre- and post-treatment and during the follow-up period in the full sample and a subset with fear-based anxiety disorder diagnoses. Change in symptom severity during active treatment was nominally associated (P < 0.05) with two SNPs. During the follow-up period, five SNPs were nominally associated with a poorer treatment response (rs806365 [CNR1]; rs2501431 [CNR2]; rs2070956 [CNR2]; rs7769940 [CNR1]; rs2209172 [FAAH]) and one with a more favorable response (rs6928813 [CNR1]). Within the fear-based subset, the effect of rs806365 survived multiple testing corrections (P < 0.0016). We found very limited evidence for an association between variants in endocannabinoid system genes and treatment response once multiple testing corrections were applied. Larger, more homogenous cohorts are needed to allow the identification of variants of small but statistically significant effect and to estimate effect sizes for these variants with greater precision in order to determine their potential clinical utility. © 2016 The Authors. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Kathryn J Lester
- School of Psychology, University of Sussex, Brighton, UK
- King's College London, MRC Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Jonathan R I Coleman
- King's College London, MRC Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Susanna Roberts
- King's College London, MRC Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Robert Keers
- King's College London, MRC Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Gerome Breen
- King's College London, MRC Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- National Institute for Health Research Biomedical Research Centre, South London and Maudsley National Health Service Trust, Beckenham, UK
| | - Susan Bögels
- Research Institute Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
| | - Cathy Creswell
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Jennifer L Hudson
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia
| | - Anna McKinnon
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia
- MRC Cognition and Brain Sciences Unit, Cambridge, UK
- Brain and Mind Research Institute, University of Sydney, Sydney, Australia
| | - Maaike Nauta
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands
| | - Ronald M Rapee
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia
| | - Silvia Schneider
- Department of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Wendy K Silverman
- Yale University School of Medicine, Child Study Center, New Haven, Connecticut
| | - Mikael Thastum
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Polly Waite
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Gro Janne H Wergeland
- Department of Child and Adolescent Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Thalia C Eley
- King's College London, MRC Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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