Psychiatry

Biography

Biography: Giampaolo perna

Abstract

In anxiety disorders, pharmacotherapy reports non response rates of 30–60% and relapses rates of 53–80%. Similar data are reported for cognitive behavioral psychotherapy. Causes of treatment-resistance are reported in chronicity of illness, severity of symptomatology, psychiatric comorbidity, physical comorbidity, personality traits and molecular causes. In this context, personalized psychiatry (PP) represents a way to come to the aid of these shortages. To date no one discussed this topic in anxiety disorders and among these panic disorder has the unique characteristic to be quite homogenous in its psychopathologic features, with a strong root in body physiology, and to be variable in responses to panic provocation procedures, to treatment options and in long term prognosis. Physiology of panic patients is different from those of healthy controls in particular for respiratory, cardiovascular and postural systems. Specific abnormal physiological functions might be the premise to the identification of differential diagnostic subgroups of patients. Moreover, in the recent years there are evidences of an association between genetic polymorphisms of serotonin transporter, 5-HT1a receptor, MAO and COMT genes and the response to treatment with drugs and with cognitive behavioral psychotherapy. Less consistent findings have been reported for social phobia and generalized anxiety disorder. The identification of genetic and physiologic markers in their interaction with clinical features might help to find tailored treatments that will ensure the best intervention possible for each patient. Parallel findings, although not yet fully consistent, have been reported for social phobia and generalized anxiety disorder.