New study: genetic variants in the monoamine system and CBT outcome in social phobia

In a collaboration between Karolinska Institutet and Uppsala University, we studied three genetic polymorphisms in the monoamine system (5-HTTLPR, COMT val158met, TPH2 G-703T) and outcome of cognitive behavioral therapy (CBT) in social anxiety disorder (SAD) in over 300 patients. This is one of the largest genetic studies ever made on adults with SAD and CBT outcome. Monoamine-related gene polymorphisms have previously been tied to amygdala reactivity, treatment efficacy and fear extinction processes and was hereby reasoned to influence the outcome of CBT. However, none of our polymorphisms were associated with CBT outcome at long term follow-up. In our subsamples we found contradictory significant effects immediately after treatment. Even though CBT is an effective treatment of anxiety disorders, many patients (25-50%) do not respond sufficiently. Therefore, there is a need to improve not only the treatments but also how patients are selected for treatment in order to optimize the efficacy. Therapygenetics attempts to explore the relationship between genetic variation and psychological treatment response. Ultimately, such knowledge could be used to tailor therapies based on patients’ biological markers, which in turn, could improve therapeutic outcome.

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Lead author Evelyn Andersson.

The secret life of scientists: freezers and why we fear them

The freezer hotel on a Saturday: Where is the party?
The freezer hotel on a Saturday: Where is the party?

We have a lot of  DNA, RNA and plasma in our rather new – 86 C freezer. What we do not like is a breakdown of the freezer with thawing of the valuable treasures in the freezer as a result. That is why there is a temperature alarm in the freezer that goes to hospital staff that call or text us if the temperature is rising. So, in the middle of a normal Saturday I had to go check on our freezer since the alarm had indicated high temperature. With a sense of urgency normally only seen in thriller movies I rushed our samples to the spare freezer that will house our things until our freezer is behaving again. Good to know that our backup system works.

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Red heart = problemos.
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The spare freezer for emergencies.

New study out: mediators of change in CBT for health anxiety

A new study is out with lead author Erik Hedman. If you wonder why we call him “pekmaskinen” (Swedish for “the manuscript machine”, check Pubmed.

The study is the first to investigate mechanisms of improvement in Internet-based cognitive behaviour therapy (CBT) for severe health anxiety. We assessed mediators as well as outcome on a weekly basis throughout treatment among participants receiving Internet-based CBT in a randomized controlled trial. The results showed that reduced perceived risk of disease, less attention to bodily symptoms, and reduced intolerance of uncertainty significantly mediated improvement in health anxiety.The findings have theoretical and clinical implications as they indicate processes that may be causally related to the improvements observed after CBT for health anxiety.

Click the link for the full text:

Hedman E, Andersson E, Andersson G, Lindefors N, Lekander M, Rück C, Ljótsson B. (2013) Mediators in Internet-Based Cognitive Behavior Therapy for Severe Health Anxiety. PLoS ONE 8(10): e77752. doi:10.1371/journal.pone.0077752

Erik "Pekmaskinen" Hedman, PhD.
Erik “Pekmaskinen” Hedman, PhD.

Interesting Karolinska OCD Master Class coming up: The neurobiology of fear learning and extinction

Kerry ResslerOn December 2nd:  a workshop by Prof Kerry Ressler, Emory University on the neurobiology of fear learning and extinction, including
1) Current psychotherapy and pharmacology treatment approaches to OCD
2) Translational human research on extinction processes to understanding CBT
3) Mouse behavioral/genetic research approaches to OCD and Extinction
4) Molecular neurobiology of extinction and future directions to enhancing treatment and CBT

More info and how to register at: https://www.facebook.com/events/571586239534400/

Winners of our first Student Award are…

We had two great nominations and choosing the winner was hard, in fact so hard that we had to find an additional extrernal reviewer to make the descision.

The winners are:

Gustaf Brander and Per Söderholm, graduates of Stockholm University for their Master Thesis: “Tilläggsbehandling som återfallsprevention efter internetadministrerad KBT vid tvångssyndrom- en randomiserad kontrollerad studie” (Adding a booster to internetbased CBT – a RCT). Supervisor: Jan Bergström.

The runners-up:

Henrik Engelmark and Niclas Stagnér, graduates of Uppsala University. Master Thesis: “Exponering med responsprevention för tvångssyndrom i ett kliniskt sammanhang – en behandlingsutvärdering på OCD-Centret i Uppsala”. (ERP for OCD – evaluated in a clinical setting”. Supervisors: Timo Hursti and Sandra Bates.

We wish to thank our review board (David Mataix-Cols, Tord Ivarsson and Susanne Bejerot).

Per Söderholm and Gustaf Brander.
Did we really win? Per Söderholm and Gustaf Brander.