Epigenetic Studies in Psychotherapy: A Systematic Review

Author(s): Rafael Penadés*, Bárbara Arias, Mar Fatjó-Vilas, Laura González-Vallespí, Clemente García-Rizo, Rosa Catalán, Miquel Bernardo

Journal Name: Current Psychiatry Research and Reviews
Formerly Current Psychiatry Reviews

Volume 16 , Issue 2 , 2020

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Graphical Abstract:


Background: Epigenetic modifications appear to be dynamic and they might be affected by environmental factors. The possibility of influencing these processes through psychotherapy has been suggested.

Objective: To analyse the impact of psychotherapy on epigenetics when applied to mental disorders. The main hypothesis is that psychological treatments will produce epigenetic modifications related to the improvement of treated symptoms.

Methods: A computerised and systematic search was completed throughout the time period from 1990 to 2019 on the PubMed, ScienceDirect and Scopus databases.

Results: In total, 11 studies were selected. The studies were evaluated for the theoretical framework, genes involved, type of psychotherapy and clinical challenges and perspectives. All studies showed detectable changes at the epigenetic level, like DNA methylation changes, associated with symptom improvement after psychotherapy.

Conclusion: Methylation profiles could be moderating treatment effects of psychotherapy. Beyond the detected epigenetic changes after psychotherapy, the epigenetic status before the implementation could act as an effective predictor of response.

Keywords: Epigenetics, DNA methylation, psychotherapy, psychopathology, gene-environment, mental disorders.

Weingarten CP, Strauman TJ. Neuroimaging for psychotherapy research: current trends. Psychother Res 2015; 25(2): 185-213.
[http://dx.doi.org/10.1080/10503307.2014.883088] [PMID: 24527694]
Penadés R, Franck N, González-Vallespí L, Dekerle M. Neuroimaging studies of cognitive function in schizophrenia. Adv Exp Med Biol 2019; 1118: 117-34.
[http://dx.doi.org/10.1007/978-3-030-05542-4_6] [PMID: 30747420]
Dekkers KF, Slagboom PE, Jukema JW, Heijmans BT. The multifaceted interplay between lipids and epigenetics. Curr Opin Lipidol 2016; 27(3): 288-94.
[http://dx.doi.org/10.1097/MOL.0000000000000301] [PMID: 27031277]
Maccari S, Krugers HJ, Morley-Fletcher S, Szyf M, Brunton PJ. The consequences of early-life adversity: neurobiological, behavioural and epigenetic adaptations. J Neuroendocrinol 2014; 26(10): 707-23.
[http://dx.doi.org/10.1111/jne.12175] [PMID: 25039443]
Kumsta R. The role of epigenetics for understanding mental health difficulties and its implications for psychotherapy research. Psychol Psychother 2019; 92(2): 190-207.
[http://dx.doi.org/10.1111/papt.12227] [PMID: 30924323]
Kandel ER. A new intellectual framework for psychiatry. Am J Psychiatry 1998; 155(4): 457-69.
[http://dx.doi.org/10.1176/ajp.155.4.457] [PMID: 9545989]
Stahl SM. Psychotherapy as an epigenetic ‘drug’: psychiatric therapeutics target symptoms linked to malfunctioning brain circuits with psychotherapy as well as with drugs. J Clin Pharm Ther 2012; 37(3): 249-53.
[http://dx.doi.org/10.1111/j.1365-2710.2011.01301.x] [PMID: 22594604]
Perroud N, Salzmann A, Prada P, et al. Response to psychotherapy in borderline personality disorder and methylation status of the BDNF gene. Transl Psychiatry 2013; 3(3)e207
[http://dx.doi.org/10.1038/tp.2012.140] [PMID: 23422958]
Lopez JP, Mamdani F, Labonte B, et al. Epigenetic regulation of BDNF expression according to antidepressant response. Mol Psychiatry 2013; 18(4): 398-9.
[http://dx.doi.org/10.1038/mp.2012.38] [PMID: 22547115]
Knoblich N, Gundel F, Brückmann C, Becker-Sadzio J, Frischholz C, Nieratschker V. DNA methylation of APBA3 and MCF2 in borderline personality disorder: potential biomarkers for response to psychotherapy. Eur Neuropsychopharmacol 2018; 28(2): 252-63.
[http://dx.doi.org/10.1016/j.euroneuro.2017.12.010] [PMID: 29274998]
Yehuda R, Daskalakis NP, Desarnaud F, et al. Epigenetic biomarkers as predictors and correlates of symptom improvement following psychotherapy in combat veterans with PTSD. Front Psychiatry 2013; 4(4): 118.
[http://dx.doi.org/10.3389/fpsyt.2013.00118] [PMID: 24098286]
Bishop JR, Lee AM, Mills LJ, et al. Methylation of FKBP5 and SLC6A4 in relation to treatment response to mindfulness based stress reduction for posttraumatic stress disorder. Front Psychiatry 2018; 9(18): 418.
[http://dx.doi.org/10.3389/fpsyt.2018.00418] [PMID: 30279666]
Vinkers CH, Geuze E, van Rooij SJH, et al. Successful treatment of post-traumatic stress disorder reverses DNA methylation marks. Mol Psychiatry 2019; 23.
[http://dx.doi.org/10.1038/s41380-019-0549-3] [PMID: 31645664]
Kahl KG, Georgi K, Bleich S, et al. Altered DNA methylation of glucose transporter 1 and glucose transporter 4 in patients with major depressive disorder. J Psychiatr Res 2016; 76: 66-73.
[http://dx.doi.org/10.1016/j.jpsychires.2016.02.002] [PMID: 26919485]
Roberts S, Lester KJ, Hudson JL, et al. Serotonin transporter corrected methylation and response to cognitive behaviour therapy in children with anxiety disorders. Transl Psychiatry 2014; 4(9)e444
[http://dx.doi.org/10.1038/tp.2014.83] [PMID: 25226553]
Roberts S, Keers R, Lester KJ, et al. HPA axis related genes and response to psychological therapies: genetics and epigenetics. Depress Anxiety 2015; 32(12): 861-70.
[http://dx.doi.org/10.1002/da.22430] [PMID: 26647360]
Ziegler C, Richter J, Mahr M, et al. MAOA gene hypomethylation in panic disorder-reversibility of an epigenetic risk pattern by psychotherapy. Transl Psychiatry 2016; 6(4)e773
[http://dx.doi.org/10.1038/tp.2016.41]] [PMID: 27045843]
Roberts S, Keers R, Breen G, et al. DNA methylation of FKBP5 and response to exposure-based psychological therapy. Am J Med Genet B Neuropsychiatr Genet 2019; 180(2): 150-8.
[http://dx.doi.org/10.1002/ajmg.b.32650] [PMID: 30334356]
Ziegler C, Grundner-Culemann F, Schiele MA, et al. The DNA methylome in panic disorder: a case-control and longitudinal psychotherapy-epigenetic study. Transl Psychiatry 2019; 9(1): 314.
[http://dx.doi.org/10.1038/s41398-019-0648-6] [PMID: 31754096]
Szyf M. DNA methylation and demethylation probed by small molecules. Biochim Biophys Acta 2010; 1799(10-12): 750-9.
[http://dx.doi.org/10.1016/j.bbagrm.2010.09.002] [PMID: 20840878]
Szyf M. Prospects for medications to reverse causative epigenetic processes in neuropsychiatry disorders. Neuropsychopharmacology 2017; 42(1): 367-8.
[http://dx.doi.org/10.1038/npp.2016.219] [PMID: 27909326]
Ovenden ES, McGregor NW, Emsley RA, Warnich L. DNA methylation and antipsychotic treatment mechanisms in schizophrenia: progress and future directions. Prog Neuropsychopharmacol Biol Psychiatry 2018; 81: 38-49.
[http://dx.doi.org/10.1016/j.pnpbp.2017.10.004] [PMID: 29017764]
Phillips T. The role of methylation in gene expression. Nature Education 2008; 1(1): 116.
Moore LD, Le T, Fan G. DNA methylation and its basic function. Neuropsychopharmacology 2013; 38(1): 23-38.
[http://dx.doi.org/10.1038/npp.2012.112] [PMID: 22781841]
Bakulski KM, Feinberg JI, Andrews SV, et al. DNA methylation of cord blood cell types: applications for mixed cell birth studies. Epigenetics 2016; 11(5): 354-62.
[http://dx.doi.org/10.1080/15592294.2016.1161875] [PMID: 27019159]
Jiménez JP, Botto A, Herrera L, et al. Psychotherapy and genetic neuroscience: an emerging dialog. Front Genet 2018; 9: 257.
[http://dx.doi.org/10.3389/fgene.2018.00257] [PMID: 30065751]

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Article Details

Year: 2020
Published on: 22 June, 2020
Page: [86 - 92]
Pages: 7
DOI: 10.2174/2666082216999200622140922
Price: $65

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