Serotonin Transporter and COMT Polymorphisms as Independent Predictors of Health-related Quality of Life in Patients with Panic Disorder

There is growing evidence of poor health-related quality of life (HRQOL) in patients with panic disorder (PD). However, little is known about the factors affecting HRQOL in patients with PD. The authors examined whether 5-HTTLPR tri-allelic approach and Cathechol-O-methyltransferase (COMT) Val(158)Met polymorphism can predict HRQOL in patients with PD controlling for sociodemographic factors and disorder-related symptom levels. The sample consisted of 179 patients with PD consecutively recruited from an outpatient clinic and age- and gender ratio-matched 110 healthy controls. The SF-36 was used to assess multiple domains of HRQOL. Hierarchical multiple regression analysis was performed to determine the independent effect of the 5-HTTLPR and COMT Val(158)Met on the SF-36 in panic patients. Patients with PD showed lowered HRQOL in all sub-domains of the SF-36 compared to healthy controls. The 5-HTTLPR independently and additively accounted for 2.2% of variation (6.7% of inherited variance) of perceived general health and the COMT Val(158)Met independently and additively accounted for 1.5% of variation (5.0% of inherited variance) of role limitation due to emotional problems in patient group. The present study suggests that specific genetic polymorphisms are associated with certain domains of HRQOL and provides a new insight on exploring the factors that predict HRQOL in patients with PD.

The Genetic Basis of Panic Disorder

Panic disorder is one of the chronic and disabling anxiety disorders. There has been evidence for either genetic heterogeneity or complex inheritance, with environmental factor interactions and multiple single genes, in panic disorder's etiology. Linkage studies have implicated several chromosomal regions, but no research has replicated evidence for major genes involved in panic disorder. Researchers have suggested several neurotransmitter systems are related to panic disorder. However, to date no candidate gene association studies have established specific loci. Recently, researchers have emphasized genome-wide association studies. Results of two genome-wide association studies on panic disorder failed to show significant associations. Evidence exists for differences regarding gender and ethnicity in panic disorder. Increasing evidence suggests genes underlying panic disorder overlap, transcending current diagnostic boundaries. In addition, an anxious temperament and anxiety-related personality traits may represent intermediate phenotypes that predispose to panic disorder. Future research should focus on broad phenotypes, defined by comorbidity or intermediate phenotypes. Genome-wide association studies in large samples, studies of gene-gene and gene-environment interactions, and pharmacogenetic studies are needed.

Aspectos geneticos do transtorno de panico / The genetics of panic disorder

O artigo apresenta uma revisao sobre a genetica do transtorno de panico, passando inicialmente pelos estudos genetico-epidemiologicos em familias e gemeos...

Estudos familiares de pacientes com transtorno do pânico: avaliação metodológica / Family studies in panic disorder: critical review

Objetivo: avaliar a metodologia utilizada nos estudos com familiares de paciente com transtorno do pânico. Método: foram avaliados estudos com familiares de pacientes com transtorno do pânico nos últimos 10 anos, através de pesquisa no MEDLINE utilizando as palavras chaves: panic disorder, family e epidemiology. Resultados: observou-se que todos os estudos divergem ou se mostravam contraditórios em relaçäo às questöes metodológicos como diferentes critérios de inclusäo e exclusäo falta de um grupo controle, critérios diagnóstico utilizados, entrevista estruturada, contato telefônico, etc.); tornando assim estes estudos passíveis de falhas relacionadas à fidedignidade do seu resultado final. Conclusäo: apesar de discrepâncias metodológicas, é importante ressaltar que todos os estudos suportam a teoria de que existe um componente genético e familiar relacionado ao transtorno do pânico

Ansiedad de separación y trastorno de pánico / Separation anxiety and panic disorder

Hemos revisado la literatura sobre la relación entre el trastorno de ansiedad de separación en la infancia y el trastorno de pánico en la edad adulta. La mayoría de los estudios apoyan esta relación al encontrar una mayor frecuencia de antecedentes de ansiedad de separación en los adultos con trastornos de ansiedad especialmente con trastorno de pánico. La ansiedad de separación parece estar implicada como un factor de riesgo precoz en el trastorno emocional del adulto. Además hemos presentado los datos de un estudio en el que se utilizó el sistema HLA para evaluar la distribución de los diferentes antígenos en los miembros de una familia con alta morbilidad de trastorno de pánico y de trastorno de ansiedad de separación. El objetivo era comprobar la existencia de los mismos haplotipos en los miembros afectados. Los resultados sugieren un componente genético común para el trastorno de pánico y el trastorno de ansiedad de separación ya que se encontró el mismo haplotipo en los seis miembros adultos de la familia con trastorno de pánico y en dos niños con trastorno de ansiedad de separación frente a la ausência en los miembros de la familia libres de estos trastornos.

Distúrbio de pânico e comorbidade clínica / Panic disorder and clinical comorbidity

Os autores abordam o distúrbio do pânico considerando nao só as manifestaçoes psiquiátricas mas também as possibilidades biológicas bem como as várias patologias que podem cursar com sintomatologia semelhante às crises de pânico.