Wellcome has awarded over £4.8m for researchers to predict individual outcomes following psychological treatments for anxiety, and to identify genetic and cognitive mechanisms.
The project, "Discovering therapeutic mechanisms and predicting psychological treatment outcome: towards stratified interventions for anxiety", is led by Professor Thalia Eley at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) with co-investigators Professor Colette Hirsch, Professor Gerome Breen and Dr Ewan Carr.
Currently, only 50% of those who receive psychological treatment for anxiety recover. Over the next six years, the team will investigate the genetic influences and underlying cognitive mechanisms that determine who benefits from psychological treatments. This information will allow them to develop and test new models which can predict individual outcomes following psychological treatment.
In the long-term, this will enable more personalised anxiety treatment based on an individual's genetic and cognitive makeup to optimise treatment outcomes.
People living with anxiety have repeatedly told us how hard finding the right treatment is. With this Wellcome funding, we can start to gain a better understanding of which treatments work and for whom and why. By understanding the genetic and cognitive mechanisms which determine how effective psychological treatments for anxiety are, we will be able to develop a model which allows us to predict individual responses before treatment starts. This will help patients decide on their treatment choices.
Professor Thalia Eley, Professor of Developmental Behavioural Genetics at King's IoPPN and project lead
The researchers will deliver the largest dataset combining cognitive processes, genetic factors and responses to psychological interventions and the first dataset to contain both NHS Talking Therapies records and genomic data. The study will recruit participants from three King's-led studies: the Genomic Links to Anxiety and Depression (GLAD) study (part of the National Institute for Health and Care Research Mental Health BioResource), Improving Black Health Outcomes (IBHO) study (part of NIHR BioResource) and Twins Early Development study, as well as the MRC Genes & Health study jointly led by Queen Mary University of London.
Using these data, they will establish for the first time which genetic factors influence outcomes following psychological treatment for anxiety. They will also investigate whether these genetic influences on treatment outcomes are mediated by cognitive processes. This will enable them to produce two prediction models, each identifying factors associated with psychological treatment response for people with anxiety.
By adding polygenic scores (which summarise the genetic variants associated with certain traits) and cognitive processes to previously established predictors of treatment response, the researchers hope their models will outperform existing models, which currently only explain around 20% of variance in responses to psychological treatments for anxiety.
The research will facilitate the future development of predictive tools to identify, before treatment starts, how likely patients are to respond to psychological treatments for anxiety, and potential alternatives.
