title: Predicting Response Trajectories during Cognitive-Behavioural Therapy for Panic Disorder: No Association with the BDNF Gene or Childhood Maltreatment.
abstract: 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).
  
  
  METHODS
  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.
authors.affiliation: Department of Mental Health, Consorci Sanitari de Terrassa, Terrassa, Spain.|Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain.
authors.forename: Martí
authors.initials: M
authors.lastname: Santacana
authors.affiliation: Anthropology Unit, Department of Animal Biology, Universitat de Barcelona, Barcelona, Spain.|CIBERSAM (Centro de Investigaciones Biomédicas en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Bárbara
authors.initials: B
authors.lastname: Arias
authors.affiliation: CIBERSAM (Centro de Investigaciones Biomédicas en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain.|Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany.
authors.forename: Marina
authors.initials: M
authors.lastname: Mitjans
authors.affiliation: Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain.
authors.forename: Albert
authors.initials: A
authors.lastname: Bonillo
authors.affiliation: Department of Mental Health, Consorci Sanitari de Terrassa, Terrassa, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Montoro
authors.affiliation: Institute of Neuropsychiatry and Addictions, Hospital del Mar, Barcelona, Spain.
authors.forename: Sílvia
authors.initials: S
authors.lastname: Rosado
authors.affiliation: Department of Mental Health, Consorci Sanitari de Terrassa, Terrassa, Spain.
authors.forename: Roser
authors.initials: R
authors.lastname: Guillamat
authors.affiliation: Department of Mental Health, Consorci Sanitari de Terrassa, Terrassa, Spain.
authors.forename: Vicenç
authors.initials: V
authors.lastname: Vallès
authors.affiliation: CIBERSAM (Centro de Investigaciones Biomédicas en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain.|Institute of Neuropsychiatry and Addictions, Hospital del Mar, Barcelona, Spain.
authors.forename: Víctor
authors.initials: V
authors.lastname: Pérez
authors.affiliation: CIBERESP (Centro de Investigaciones Biomédicas en Red, Epidemiología y Salud Pública), Instituto de Salud Carlos III, Madrid, Spain.|Health Services Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain.|Department of Experimental and Life Sciences (DCEXS), Universitat Pompeu Fabra, Barcelona, Spain.
authors.forename: Carlos G
authors.initials: CG
authors.lastname: Forero
authors.affiliation: Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain.|Institute of Neuropsychiatry and Addictions, Hospital del Mar, Barcelona, Spain.
authors.forename: Miquel A
authors.initials: MA
authors.lastname: Fullana
mesh_terms: D000293:Adolescent; D000328:Adult; D019208:Brain-Derived Neurotrophic Factor / Q000235:genetics*; D002649:Child Abuse; D015928:Cognitive Behavioral Therapy; D005260:Female; D014644:Genetic Variation; D015894:Genome, Human; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D016584:Panic Disorder / Q000150:complications / Q000628:therapy*; D011110:Polymorphism, Genetic; D011615:Psychotherapy, Group; D011788:Quality of Life; D012044:Regression Analysis; D055815:Young Adult
chemical_list: D019208:Brain-Derived Neurotrophic Factor; C579455:BDNF protein, human