New meta-analysis on genes and psychotherapy outcome 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. In a new study, published today, we performed 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 Original data were obtained from ten independent samples (including three unpublished samples) with a total of 2,195 patients with primary anxiety disorder.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.

Read the full paper:
Schiele, M. A., Reif, A., Lin, J., Alpers, G. W., Andersson, E., Andersson, G., Arolt, V., Bergström, J., Carlbring, P., Eley, T. C., Esquivel, G., Furmark, T., Gerlach, A. L., Hamm, A., Helbig-Lang, S., Hudson, J. L., Lang, T., Lester, K. J., Lindefors, N., Lonsdorf, T. B., Pauli, P., Richter, J., Rief, W., Roberts, S., Rück, C., Schruers, K. R. J., Thiel, C., Wittchen, H.-U., Domschke, K., Weber, H., & Lueken, U. (2021). Therapygenetic effects of 5-HTTLPR on cognitive-behavioral therapy in anxiety disorders: A meta-analysis. European Neuropsychopharmacology, 44, 105-120. doi:10.1016/j.euroneuro.2021.01.004