Barcelona snapshots

Prof. Thalia Eley

Thalia Eley psychiatrist Controversies Psiquiatry Barcelona
King’s College London, United Kingdom
Talk Precision in psychotherapy; is therapygenetics coming soon?
Date Friday, April 21st, 2023
Time 15:20 - 16:05
Round Table 3 Precision in clinical psychology


Thalia Eley is Professor of Developmental Behavioural Genetics at the Institute of Psychiatry, Psychology & Neuroscience, King’s College London. She directs the Emotional Development, Intervention and Treatment (EDIT) lab, and her work focuses on the interplay between genetic and environmental factors in the development and treatment of anxiety and depression.

Her work is highly interdisciplinary using both the twin design and molecular genetic approaches, and drawing on cognitive, clinical and developmental psychology. She has written over 240 empirical papers and received numerous awards including the Spearman Medal from the British Psychological Society, the Lilly-Molecular Psychiatry Award, and most recently the James Shields Lifetime Achievement Award from the International Society for Twin Studies. She is one of the leads of the Genetic Links to Anxiety and Depression (GLAD) Study, is Director of the Twins Early Development Study (TEDS) and is one of the Chairs of the Psychiatric Genomics Consortium Anxiety Group. She is particularly interested in finding ways in which genetic approaches can inform psychological practise as well as theory.


Anxiety and depression and common and debilitating conditions. They are typically treated with either pharmacological or psychological interventions. However, many individuals experience barriers to treatment, particularly psychological approaches, and whilst these are effective for many around 50% of individuals do not respond. As a result, considerable effort is being invested in identifying predictors of treatment outcomes. Specifically, if we can build models that accurately predict outcome using information available at the start of treatment, we could potentially identify individual for whom treatment augmentation or another treatment altogether is required. This talk will focus on prediction of outcomes for psychological treatment, particularly cognitive-behaviour therapy (CBT). There are well-replicated clinical and demographic factors that are associated with CBT response. Clinical factors include comorbidity, severity, family history, taking psychotropic medication and some specific diagnoses (e.g. social anxiety disorder). Demographic factors include lack of employment and presence of disability. The exploration of genetic factors involved in psychological treatment response, or "therapygenetics" is a relatively new field, with modest though growing evidence.

Focussing on psychological treatment outcomes, this talk will describe work to date examining the role of demographic, clinical and genetic factors in treatment seeking, treatment receipt and treatment outcome. Particular attention will be paid to the therapygenetics literature, and the extent to which genetic information appears likely to contribute usefully to prediction above and beyond that gained from clinical and demographic factors alone. Data will be presented from twin analyses of (a) self-reported psychological treatment outcomes and (b) fear extinction, a mechanism thought to underlie the efficacy of the behavioural component of CBT. Genome-wide genetic analyses will be presented from a series of individual studies and meta-analyses. These take a range of approaches to assessing outcome including prospectively collected data during either clinical trials or treatment-as-usual, and retrospectively self-reported treatment outcomes. Finally, studies to date that have used genome-wide polygenic data to predict treatment response over and above clinical and demographic factors will be discussed.

The talk will end with a discussion of future directions, including ethical and practical issues involved in utilising scores that could predict someone will not respond in clinical practise.


[Full paper] Eley, T. C. (2014). The future of therapygenetics: Where will studies predicting psychological treatment response from genomic markers lead?. Depression and Anxiety, 31, 617-620. doi: 10.1002/da.22292

[Full paper] Rayner, C., ... Breen, G., & Eley, T. C. (2019). Genetic influences on treatment-seeking for common mental health problems in the UK Biobank. Behaviour Research and Therapy, 121, 103413 doi: 10.1016/j.brat.2019.103413

[Full paper] Rayner, C., ... Rück, C., Breen, G., & Eley, T. C. (2019). A genome-wide association meta-analysis of prognostic outcomes following cognitive behavioural therapy in individuals with anxiety and depressive disorders. Translational Psychiatry, 9, 150. doi: 10.1038/s41398-019-0481-y.

[Full paper] Wallert, J., Boberg, J., Kravchenko, O., Kaldo, V., Mataix-Cols, D., Crowley, J., & Rück, C. (2022). Polygenic risk scores, data-driven longitudinal clusters of weekly symptom trajectories, and psot psychotherapy remission in major depressive disorder. European Neuropsychopharmacology, 63, e192-e193.

[Full paper] Purves, K. L., ... Breen, G., & Eley, T. C. (2023). Evidence for distinct genetic and environmental influences on fear acquisition and extinction. Psychological Medicine, 53, 1106-1114. doi: 10.1017/S0033291721002580