EL GEN DEL BDNF I EL MALTRACTAMENT INFANTIL EN LA PREDICCIÓ DE LA RESPOSTA A LA TERÀPIA COGNITIVOCONDUCTUAL PEL TRASTORN DE PÀNIC

Abstract

Anxiety disorders cause a huge social and economic burden, and result in low quality of life of those affected. Fortunately, there are effective treatments for anxiety disorders, such as the selective serotonin reuptake inhibitors or cognitive-behavioural therapy. However, a substantial proportion of patients does not respond to these treatments, and identifying which factors are associated with poor treatment outcome is now a research priority. In this context, and from a translational perspective, the present Ph D dissertation seeks to be a contribution to the study of predictors of outcome. Firstly, we_x000D_ assessed the psychometric properties and factorial structure of the Spanish version of the Panic Disorder Severity Scale - Self Report (PDSS-SR) -study 1-. _x000D_ Our results confirm that the Spanish version of the PDSS-SR is a suitable instrument for assessing panic/agoraphobia symptoms in Spanish-speaking contexts. Given that it is an easy-to-administer tool, it can be broadly applied and it should allow to carry out cross-cultural research, which was not possible because a validated Spanish version was not available. Secondly, we tested whether the BDNF Val66Met polymorphism and/or childhood maltreatment are associated with a worse response trajectory during cognitive-behavioural therapy for panic disorder -study 2-. Prompted by previous evidence, we hypothetised that both the Met allele of the BDNF gene and childhood maltreatment would be associated with a less favorable response trajectory. However, we found no evidence to support an association between treatment outcome and either of these variables. Despite the negative results, our data add to the expanding body of evidence on which predictors of treatment outcome are clinically relevant for anxiety disorders, and this type of information will ultimately lead to better interventions that are more precisely tailored to patient profiles. In addition, since our hypothesis could not be confirmed, this work guides research in this field to other variables (e.g., epigenetic) that may modulate the response to psychological treatment in panic disorder, and possibly in other disorders as well.

Date of Award	20 Dec 2016
Original language	Catalan
Supervisor	Miguel Ángel Fullana Rivas (Director) & Bárbara Arias Sampériz (Director)