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多基因风险与强迫症治疗后认知行为疗法后症状严重性变化之间的关联
Julia Bäckman1, John Wallert1, Matthew Halvorsen1,2
1Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
概括
多基因风险评分 (PRS) 被评估用于预测接受认知行为疗法 (CBT) 的强迫症 (OCD) 患者的治疗反应. 对于精神分裂症来说,较高的PRS与较少的症状改善有关,但整体PRS实用性有限.
科学领域:
- 精神病学是一个精神病学.
- 遗传学 是一个遗传学.
- 临床心理学 临床心理学
背景情况:
- 许多患有强迫症 (OCD) 的患者对认知行为疗法 (CBT) 的反应不足.
- 识别治疗反应的预测因素对于个性化干预和避免治疗失败至关重要.
- 关于强迫症中CBT反应预测因子的先前研究已经产生了不一致和临床上有限的发现.
研究的目的:
- 调查9个多基因风险评分 (PRS) 对接受CBT的强迫症患者精神和认知特征的预测价值.
- 评估PRS与经CBT后强迫症症状严重程度的变化之间的关联.
主要方法:
- 分析了在瑞典和挪威接受CBT治疗的1598名强迫症患者 (成人和儿童/青少年) 的队列.
- 线性混合模型被用来估计PRS和症状严重程度变化之间的关联,调整共变量.
- 对精神病和认知特征的9个PRS被检查为潜在的预测因素.
主要成果:
- 在精神分裂症的更高PRS和强迫症症状严重程度的较小下降之间发现了适度显著的关联 (β=0.013,p=0.04,R2=0.10).
- 没有其他PRS表明与症状严重程度的变化有显著的关联.
- 在这种情况下,目前PRS对精神病和认知表型的整体预测效用是有限的.
结论:
- 目前针对精神和认知特征的多基因风险评分似乎不是对强迫症的CBT症状严重性变化的有意义预测.
- 需要进一步的研究来验证这些发现,并探索其他潜在的遗传或临床预测因素.
- 目前PRS的有限实用性表明,需要开发更精细的遗传标记来预测强迫症治疗反应.
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