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Predicting treatment outcome for anxiety disorders with or without comorbid depression using clinical, imaging and (epi)genetic data

Deckert, Jürgena; Erhardt, Angelikab

Current Opinion in Psychiatry: January 2019 - Volume 32 - Issue 1 - p 1–6
doi: 10.1097/YCO.0000000000000468
MOOD AND ANXIETY DISORDERS: Edited by Sidney H. Kennedy and Hans-Ulrich Wittchen

Purpose of review The present review complements previous reviews on prediction research in anxiety disorders with a focus on clinical, imaging and genetic as well as epigenetic factors and aims to provide recommendations for the design of future integrative studies in adults as well as children.

Recent findings Clinical factors predicting worse outcome such as a diagnosis of social anxiety disorder, comorbid depression and certain cognitive, behavioral and personality traits as well as low socioeconomic status were confirmed in large clinical studies. Imaging factors focusing on the fear and anxiety network were repeatedly described as predicting therapy response in small exploratory studies. The plethora of candidate gene studies has now been complemented by large genome-wide association studies and small epigenetic investigations with the need for replication in larger samples.

Summary The present status of research on predictors for therapy response in anxiety disorders, in particular on imaging and genetic factors, is still fragmentary. Some clinical factors for poorer outcome, though, have been consistently replicated and should be considered in the revision of therapy guidelines. There is a definite need for large integrative studies at the national and international level integrating multiple levels of biomarkers at different stages of development.

aDepartment of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Würzburg

bMax-Planck-Institute for Psychiatry, München, Germany

Correspondence to Jürgen Deckert, Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Margarete-Höppel-Platz 1, 97080 Würzburg, Germany. Tel: +00 49 931 201 77000; fax: +00 49 931 201 77020; e-mail:

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