Association Study of Trauma Load and SLC6A4 Promoter Polymorphism in Posttraumatic Stress Disorder : Evidence From Survivors of the Rwandan Genocide

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2010
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Kolassa, Stephan
Papassotiropoulos, Andreas
Quervain, Dominique J.-F. de
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Stress and trauma-associated immunological changes and their implications on health
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Journal of Clinical Psychiatry ; 71 (2010), 5. - pp. 543-547
Abstract
Objective: As exposure to different types of traumatic stressors increases, the occurrence of posttraumatic stress disorder (PTSD) increases. However, because some people exhibit either surprising resilience or high vulnerability, further influencing factors have been conjectured, such as gene-environment interactions. The SLC6A4 gene, which encodes serotonin transporter, has been identified as predisposing toward differential emotional processing between genotypes of its promoter polymorphism.
Method: We investigated 408 refugees from the Rwandan genocide and assessed lifetime exposure to traumatic events, PTSD (according to DSM-IV) status, and genotype of the SLC6A4 promoter polymorphism. The study was conducted from March 2006 to February 2007.
Results: The prevalence of PTSD approached
100% when traumatic exposure reached extreme levels. However, persons homozygous for the short allele of the SLC6A4 promoter polymorphism showed no dose-response relationship but were at high risk for developing PTSD after very few traumatic events. This genotype influence vanished with increasing exposure to traumatic stressors. Conclusion: We find evidence for a geneenvironment interplay for PTSD and show that genetic influences lose importance when environmental factors cause an extremely high trauma burden to an individual. In the future, it may be important to determine whether the effectiveness of therapeutic interventions in PTSD is also modulated by the SLC6A4 genotype.
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ISO 690KOLASSA, Iris-Tatjana, Verena ERTL, Cindy ECKART, Franka THURM, Stephan KOLASSA, Andreas PAPASSOTIROPOULOS, Dominique J.-F. de QUERVAIN, Thomas ELBERT, 2010. Association Study of Trauma Load and SLC6A4 Promoter Polymorphism in Posttraumatic Stress Disorder : Evidence From Survivors of the Rwandan Genocide. In: Journal of Clinical Psychiatry. 71(5), pp. 543-547. Available under: doi: 10.4088/JCP.08m04787blu
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@article{Kolassa2010Assoc-13420,
  year={2010},
  doi={10.4088/JCP.08m04787blu},
  title={Association Study of Trauma Load and SLC6A4 Promoter Polymorphism in Posttraumatic Stress Disorder : Evidence From Survivors of the Rwandan Genocide},
  number={5},
  volume={71},
  journal={Journal of Clinical Psychiatry},
  pages={543--547},
  author={Kolassa, Iris-Tatjana and Ertl, Verena and Eckart, Cindy and Thurm, Franka and Kolassa, Stephan and Papassotiropoulos, Andreas and Quervain, Dominique J.-F. de and Elbert, Thomas}
}
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