The COMTval158met polymorphism is associated with symptom relief during exposure-based cognitive-behavioral treatment in panic disorder.
BACKGROUND
Cognitive behavioral therapy (CBT) represents a learning process leading to symptom relief and resulting in long-term changes in behavior. CBT for panic disorder is based on exposure and exposure-based processes can be studied in the laboratory as extinction of experimentally acquired fear responses. We have recently demonstrated that the ability to extinguish learned fear responses is associated with a functional genetic polymorphism (COMTval158met) in the COMT gene and this study was aimed at transferring the experimental results on the COMTval158met polymorphism on extinction into a clinical setting.


METHODS
We tested a possible effect of the COMTval158met polymorphism on the efficacy of CBT, in particular exposure-based treatment modules, in a sample of 69 panic disorder patients.


RESULTS
We present evidence that panic patients with the COMTval158met met/met genotype may profit less from (exposure-based) CBT treatment methods as compared to patients carrying at least one val-allele. No association was found with the 5-HTTLPR/rs25531 genotypes which is presented as additional material.


CONCLUSIONS
We were thus able to transfer findings on the effect of the COMTval158met polymorphism from an experimental extinction study obtained using healthy subjects to a clinical setting. Furthermore patients carrying a COMT val-allele tend to report more anxiety and more depression symptoms as compared to those with the met/met genotype. Limitations of the study as well as possible clinical implications are discussed.


BACKGROUND
Clinical Trial Registry name: Internet-Versus Group-Administered Cognitive Behavior Therapy for Panic Disorder (IP2). Registration Identification number: NCT00845260, http://www.clinicaltrials.gov/ct2/show/NCT00845260.
Psychology Section, Karolinska Institutet, Fogdevreten 2a, 17176 Stockholm, Sweden. t.lonsdorf@uke.de
Tina B
TB
Lonsdorf
Christian
C
Rück
Jan
J
Bergström
Gerhard
G
Andersson
Arne
A
Ohman
Nils
N
Lindefors
Martin
M
Schalling
D000328:Adult; D002394:Catechol O-Methyltransferase / Q000235:genetics*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005108:Extinction, Psychological; D005239:Fear / Q000523:psychology; D005260:Female; D005838:Genotype; D006801:Humans; D007171:Implosive Therapy / Q000379:methods*; D008297:Male; D008715:Methionine / Q000235:genetics; D008875:Middle Aged; D016584:Panic Disorder / Q000235:genetics* / Q000523:psychology / Q000628:therapy*; D011110:Polymorphism, Genetic; D050486:Serotonin Plasma Membrane Transport Proteins / Q000235:genetics; D016896:Treatment Outcome; D014633:Valine / Q000235:genetics
C493230:SLC6A4 protein, human; D050486:Serotonin Plasma Membrane Transport Proteins; D008715:Methionine; D002394:Catechol O-Methyltransferase; D014633:Valine