The Genetic Basis of Panic Disorder

Abstract

Panic disorder is one of the chronic and disabling anxiety disorders. There has been evidence for either genetic heterogeneity or complex inheritance, with environmental factor interactions and multiple single genes, in panic disorder's etiology. Linkage studies have implicated several chromosomal regions, but no research has replicated evidence for major genes involved in panic disorder. Researchers have suggested several neurotransmitter systems are related to panic disorder. However, to date no candidate gene association studies have established specific loci. Recently, researchers have emphasized genome-wide association studies. Results of two genome-wide association studies on panic disorder failed to show significant associations. Evidence exists for differences regarding gender and ethnicity in panic disorder. Increasing evidence suggests genes underlying panic disorder overlap, transcending current diagnostic boundaries. In addition, an anxious temperament and anxiety-related personality traits may represent intermediate phenotypes that predispose to panic disorder. Future research should focus on broad phenotypes, defined by comorbidity or intermediate phenotypes. Genome-wide association studies in large samples, studies of gene-gene and gene-environment interactions, and pharmacogenetic studies are needed.

Panic Disorder and Migraine: Comorbidity, Mechanisms, and Clinical Implications

“…87 Future studies should attend to entire genetic regions and take a syndrome approach by expanding phenotype definitions beyond diagnostic criteria of single disorders to include multiple common comorbid medical and psychiatric conditions. 48,56,84,88,89 Consistent with a syndrome model, migraine and anxiety have been associated with the serotonin transporter gene 5-HTTLPR polymorphism. 90 Several studies have reported a genetic linkage between anxiety disorders such as PD and various medical conditions (eg, migraine, chronic headache, mitral valve problems) evident around the region of chromosome 13.…”

“…Future studies should attend to entire genetic regions and take a syndrome approach by expanding phenotype definitions beyond diagnostic criteria of single disorders to include multiple common comorbid medical and psychiatric conditions . Consistent with a syndrome model, migraine and anxiety have been associated with the serotonin transporter gene 5‐HTTLPR polymorphism .…”

“…Similarly, a specific dopamine receptor genotype, the Nco I polymorphism within the DRD2 gene, has been associated with comorbid migraine and PD (among other mood/anxiety disorders), suggesting a possible genetically based syndrome . Additional genetic analyses are clearly needed, such as those involving neuroimaging phenotype designs and consideration of syndromal influences …”

Anxiety and Adverse Coronary Artery Disease Outcomes in Chinese Patients

“…However, the impact of anxiety symptoms on the survival of patients with CAD is still controversial (1,9Y15). Besides, there are studies showing that ethnicity and culture are important factors in shaping psychopathology and pharmacotherapeutic responses in patients with anxiety (16,17). Whether these differences could result in different cardiovascular outcomes in different ethnicities is uncertain.…”

The assessment and treatment of panic disorder in general practice

“…However, these findings have not been consistently replicated and no specific susceptibility loci have been established. [27][28][29] Thus, a genome-wide association approach is increasingly being used to delineate such loci. 30,31 Additional, genome-wide association studies in larger population samples, as well as gene-environment interaction studies, are needed to confirm preliminary results.…”