A multi-site study of the genetics of child anxiety and predictors of treatment response

儿童焦虑遗传学和治疗反应预测因素的多中心研究

• 批准号: G0901874/1
• 负责人: Thalia Eley
• 金额: $ 73.59万
• 依托单位: King's College London
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2010
• 资助国家: 英国
• 起止时间: 2010 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=G0901874%2F1
• 关键词: multi; site; study; genetics; child

Background: Anxiety is a common and debilitating problem for our youth, shows continuity into adulthood and is associated with wide-ranging difficulties. Those individuals who first experience an anxiety disorder during their childhood show the poorest long-term outcomes. For example, such children are much more likely than other children to be absent for significant portions of their schooling missing out on the opportunity for both social and academic development. Whilst it is clear that both genetic and environmental influences are important in the development of anxiety, we know relatively little about the specific factors and mechanisms involved. More is known about the genetics of depression, which has been shown to be genetically similar to anxiety, thus providing several useful starting points for genetic studies of anxiety. Finally, whilst child anxiety is most commonly treated using a ?talking treatment? called cognitive-behaviour therapy (CBT), around two-fifths of patients do not improve. Younger girls seem more likely to respond well, whereas those with worse symptoms or whose parents also have difficulties with anxiety and/or depression respond less well. These two factors suggest that these children may have a heavier genetic loading for anxiety, implying a possible genetic influence on treatment response. Research Plan: Genes for which there is theoretical and experimental evidence for involvement in anxiety or depression will be considered in this study. For example, genes involved in the serotonin system, the target of common anti-depressants such as Prozac, have been shown to play a role in the development and pharmacological treatment of depression, and in several anxiety-related characteristics such as extreme shyness in children. We will consider the role of these and other selected genes in the development and treatment of child anxiety. DNA (genetic material) collected from a sample of 2500 children with clinical anxiety, most of whom are being treated with CBT will be used to examine two core questions. First, are there specific genes associated with childhood anxiety disorders? Second, can we predict treatment outcome from factors such as age, sex, severity of anxiety, parental mental health and specific genes? Identifying genes relevant to the development of anxiety disorders could enable targeted prevention work, whilst knowledge of genes relevant to treatment response could allow for individualised treatment programmes.

背景资料：焦虑是一个常见的和削弱我们的青年问题，显示持续到成年，并与广泛的困难。那些在童年时期首次经历焦虑症的人表现出最差的长期结果。例如，这些儿童比其他儿童更有可能在相当长的一段时间里缺课，从而错过了社会和学术发展的机会。虽然很明显，遗传和环境影响在焦虑的发展中都很重要，但我们对所涉及的具体因素和机制知之甚少。人们对抑郁症的遗传学有了更多的了解，抑郁症在遗传学上与焦虑症相似，这为焦虑症的遗传学研究提供了几个有用的起点。最后，虽然儿童焦虑症是最常见的治疗使用？谈论治疗？这种疗法被称为认知行为疗法（CBT），大约五分之二的患者没有改善。年轻的女孩似乎更有可能做出良好的反应，而那些症状更严重或父母也有焦虑和/或抑郁困难的女孩的反应不太好。这两个因素表明，这些儿童可能有更重的焦虑遗传负荷，这意味着可能对治疗反应的遗传影响。研究计划：在这项研究中，将考虑有理论和实验证据表明参与焦虑或抑郁的基因。例如，参与血清素系统的基因，即百忧解等常见抗抑郁药的靶点，已被证明在抑郁症的发展和药物治疗中发挥作用，并在几个与焦虑相关的特征中发挥作用，如儿童的极度害羞。我们将考虑这些和其他选定的基因在儿童焦虑症的发展和治疗中的作用。从2500名患有临床焦虑症的儿童样本中收集的DNA（遗传物质），其中大多数正在接受CBT治疗，将用于检查两个核心问题。首先，是否有特定的基因与儿童焦虑症有关？第二，我们能否从年龄、性别、焦虑的严重程度、父母的心理健康和特定基因等因素来预测治疗结果？识别与焦虑症发展相关的基因可以实现有针对性的预防工作，而与治疗反应相关的基因的知识可以允许个性化的治疗方案。