title: Therapygenetics: 5-HTTLPR genotype predicts the response to exposure therapy for agoraphobia.
abstract: This study was intended to assess the extent to which the low-expression allele of the serotonin transporter gene promoter predicts better response to exposure-based behavior therapy in patients with panic disorder with agoraphobia (PDA). Ninety-nine patients with PDA underwent a 1-week in vivo exposure-based behavior therapy program and provided saliva samples to extract genomic DNA and classify individuals according to four allelic forms (SA, SG, LA, LG) of the 5-HTT-linked polymorphic region (5-HTTLPR). We determined whether the 5-HTTLPR genotype predicted change in avoidance behavior in PDA following treatment. After controlling for pre-treatment avoidance behavior, the 5-HTTLPR low-expression genotypes showed a more favorable response to exposure therapy two weeks following treatment, compared to the other patients. This study suggests a genetic contribution to treatment outcome following behavior therapy and implicates the serotonergic system in response to exposure-based treatments in PDA.
authors.affiliation: School for Mental Health en Neuroscience, Maastricht University and Mondriaan, Vijverdalseweg 1, gebouw Concorde, 6226 NB Maastricht, The Netherlands. Electronic address: i.knuts@maastrichtuniversity.nl.
authors.forename: Inge
authors.initials: I
authors.lastname: Knuts
authors.affiliation: School for Mental Health en Neuroscience, Maastricht University,Maastricht, The Netherlands.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Esquivel
authors.affiliation: School for Mental Health en Neuroscience, Maastricht University,Maastricht, The Netherlands.
authors.forename: Gunter
authors.initials: G
authors.lastname: Kenis
authors.affiliation: School for Mental Health en Neuroscience, Maastricht University,Maastricht, The Netherlands.
authors.forename: Thea
authors.initials: T
authors.lastname: Overbeek
authors.affiliation: School for Mental Health en Neuroscience, Maastricht University,Maastricht, The Netherlands.
authors.forename: Nicole
authors.initials: N
authors.lastname: Leibold
authors.affiliation: School for Mental Health en Neuroscience, Maastricht University,Maastricht, The Netherlands.
authors.forename: Lies
authors.initials: L
authors.lastname: Goossens
authors.affiliation: School for Mental Health en Neuroscience, Maastricht University,Maastricht, The Netherlands.
authors.forename: Koen
authors.initials: K
authors.lastname: Schruers
mesh_terms: D000328:Adult; D000379:Agoraphobia / Q000150:complications / Q000235:genetics* / Q000534:rehabilitation*; D000704:Analysis of Variance; D005260:Female; D005787:Gene Frequency; D005820:Genetic Testing; D005838:Genotype; D006801:Humans; D007171:Implosive Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic / Q000235:genetics*; D011401:Promoter Regions, Genetic / Q000235:genetics; D011569:Psychiatric Status Rating Scales; D050486:Serotonin Plasma Membrane Transport Proteins / Q000235:genetics*; D013001:Somatoform Disorders / Q000150:complications; D016896:Treatment Outcome
chemical_list: C493230:SLC6A4 protein, human; D050486:Serotonin Plasma Membrane Transport Proteins
keywords: Agoraphobia; Behavior therapy; Exposure therapy; Genetics; Panic disorder; Serotonin