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Improving PTSD care through genetics

Although sparked by trauma, PTSD has a genetic component as well, which can influence what therapy is most successful and provide other insights.

After experiencing or witnessing a traumatic event, such as war or childhood abuse, some people develop post traumatic stress disorder. Patients with PTSD suffer from symptoms such as nightmares, anxiety and difficult sleeping, all of which greatly impact their quality of life.

The go-to therapy for PTSD is talk therapy. However, many patients who are suffering as a result of a past trauma don't respond well to talk therapy, leaving them without any viable treatment options.

Laramie Duncan, PhD, an assistant professor of psychiatry and behavioral sciences at Stanford, believes there has to be a better way to help these patients. In a recent paper, Duncan reviewed 25 years of PTSD genetic research, including approximately 10 genome locations that contribute to PTSD. Duncan believes this is the first step in creating better, more personalized treatment for patients who need more specialized care.

I recently spoke with her to learn more.

What led you to studying the relationship between PTSD and genes?

Knowing that all psychiatric disorders have a genetic basis, it means that we can use genetic tools to get really detailed information about the underlying biology.

What really inspired me was seeing the incredible opportunity offered by modern genetic tools, which allow us to pinpoint the aspects of biology that are connected to the disorder.

What is your current research focused on?

We're using large-scale genetic approaches to find the genetic basis of disorders like schizophrenia and PTSD.

When I say large-scale genetic approaches, what I mean is that we use data from tens or even hundreds of thousands of people and then we look at millions of places in the genome for each person to find out what aspects of biology are relevant to each of these disorders. That's an approach that has really taken off in the last few years.

Researchers had laid the ground work decades before by discovering that PTSD has a genetic basis using twin studies and family studies. Very recently, we were able to use molecular genetic data to confirm those findings and to extend them in new ways.

Will this research improve future PTSD treatment methods?

What causes PTSD is experiencing trauma. But then we also know that there are individual differences in how people respond to trauma.

That's where I think the genetics work comes in. We want to be able to understand who will develop PTSD and why. Ultimately we hope to better predict who will respond to talk therapy as we currently offer it and who isn't going to respond as well and might need something else to assist in the process.

What surprised you most about your findings?

An interesting finding is that genetic influences on PTSD appear to be stronger in women than men. Intriguingly, our molecular genetic findings were consistent with previous family-based studies, giving us more confidence in these results.

The difference between females and males was really a surprise to us. We actually don't know why this is the case, but we’re following up on it now.

Unlike earlier PTSD gene studies that tended to have small sample sizes and predominately male patients, this review covers a large and diverse population. With such an inclusive set of data, Duncan said she hopes this work can help a wide range of patients receive the treatment they deserve.

Photo by Dr. Valerie Rice/ U.S. Army

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