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

BACKGROUND: 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). METHOD: 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. RESULTS: 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. CONCLUSIONS: 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.This work was supported by a grant from Carlos III Health Institute/Fondo Europeo de Desarrollo Regional (www.isciii.es) to MAF (PI12/00273). The authors of this report would also like to thank the support of the Spanish Ministry of Economy and Competitivity PN 2008-2011 -Carlos III Health Institute/Fondo Europeo de Dessarrollo Regional-(PI1200018; www.mineco.gob.es), Centro de Investigación Biomédica en Red - Salud Mental-(www.cibersam.es), and the Universities and Research Secretariat, Ministry of the Vice-presidency and of the Economy and Finance of the Catalan Government (2014 SGR 1636; http://universitatsirecerca.gencat.cat/)