“…Predisposing genetic factors may include common variants on single nucleotide polymorphisms (SNPs) in genes associated with cortisol metabolism (SRD5A2) (Steen et al 2010), the regulation of cortisol (glucocorticoid receptor, NR3C1) (Schatzberg et al 2014), dopamine catabolism (catechol-omethyltransfease COMT; dopamine D4 receptor gene (DRD4) (Jabbi et al 2007), inhibitory neurotransmittors (GABA a6 receptor subunit gene; GABRA6) (Uhart et al 2004) and stress-vulnerability (serotonin transporter-linked polymorphic region; 5-HTTLPR) (Miller et al 2013). Similarly, environmental factors such as substance abuse (Lopez-Larson et al 2011;Gavrieli et al 2011), sleep deprivation (Spiegel et al 1999), dietary changes (Cheng and Li 2012), lower socioeconomic status (Rudolph et al 2014) and a lower level of education (Karlamangla et al 2013) may contribute to the increased cortisol. While it remains unclear whether elevated cortisol levels are a risk factor for these disorders or a consequence of onset, recent studies suggest that it may be an interaction of the two (Wang et al 2011;Aina 2013;Perroud et al 2011).…”