4.5 Article

Therapygenetic effects of 5-HTTLPR on cognitive-behavioral therapy in anxiety disorders: A meta-analysis

Journal

EUROPEAN NEUROPSYCHOPHARMACOLOGY
Volume 44, Issue -, Pages 105-120

Publisher

ELSEVIER
DOI: 10.1016/j.euroneuro.2021.01.004

Keywords

Serotonin transporter gene; Therapygenetics; Treatment response; Therapy outcome; CBT; Panic disorder

Funding

  1. German Research Foundation (DFG) [44541416 -TRR 58, SFB 1193 Z03]
  2. German Ministry of Research and Education (BMBF, PROTECT-AD) [01EE1402F]
  3. UK Medical Research Council [G0901874]
  4. German Federal Ministry of Education and Research (BMBF) as part of the larger BMBF Psychotherapy Research Funding Initiative Improving the Treatment of Panic Disorder [01GV0614]
  5. MRC [G0901874] Funding Source: UKRI

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A meta-analysis was conducted on the role of the serotonin transporter gene linked polymorphic region (5-HTTLPR) in moderating the outcome of cognitive behavioral therapy (CBT) in anxiety disorders. Results showed no significant effects of 5-HTTLPR genotype on treatment outcomes at post-treatment and follow-up, indicating that this gene may not be a moderator for CBT outcomes in anxiety disorders.
There is a recurring debate on the role of the serotonin transporter gene linked polymorphic region (5-HTTLPR) in the moderation of response to cognitive behavioral therapy (CBT) in anxiety disorders. Results, however, are still inconclusive. We here aim to perform a meta-analysis on the role of 5-HTTLPR in the moderation of CBT outcome in anxiety disorders. We investigated both categorical (symptom reduction of at least 50%) and dimensional outcomes from baseline to post-treatment and follow-up. Original data were obtained from ten independent samples (including three unpublished samples) with a total of 2,195 patients with primary anxiety disorder. No significant effects of 5-HTTLPR genotype on categorical or dimensional outcomes at post and follow-up were detected. We conclude that current evidence does not support the hypothesis of 5-HTTLPR as a moderator of treatment outcome for CBT in anxiety disorders. Future research should address whether other factors such as long-term changes or epigenetic processes may explain further variance in these complex gene-environment interactions and molecular-genetic pathways that may confer behavioral change following psychotherapy. Crown Copyright (C) 2021 Published by Elsevier B.V. All rights reserved.

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