A neurobiological framework of separation anxiety and related phenotypes.

Journal: European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology

Volume: 33

Issue: 

Year of Publication: 2021

Affiliated Institutions:  Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy. Department of Psychiatry and Psychotherapy, University Medical Centre Göttingen, Germany. Clinical and Experimental Sciences, University of Southampton, Faculty of Medicine, Southampton, United Kingdom; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa. Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy. Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Center for Basics in NeuroModulation, Faculty of Medicine, University of Freiburg, Germany. Electronic address: katharina.domschke@uniklinik-freiburg.de.

Abstract summary 

In the DSM-5, separation anxiety disorder (SAD) is newly classified in the chapter on anxiety, renewing research efforts into its etiology. In this narrative review, we summarize the current literature on the genetic, endocrine, physiological, neural and neuropsychological underpinnings of SAD per se, SAD in the context of panic disorder, separation anxiety symptoms, and related intermediate phenotypes. SAD aggregates in families and has a heritability of ~43%. Variants in the oxytocin receptor, serotonin transporter, opioid receptor µ1, dopamine D4 receptor and translocator protein genes have all been associated with SAD. Dysregulation of the hypothalamus-pituitary-adrenal axis, dysfunctional cortico-limbic interaction and biased cognitive processing seem to constitute further neurobiological markers of separation anxiety. Hypersensitivity to carbon dioxide appears to be an endophenotype shared by SAD, panic disorder and anxiety sensitivity. The identification of biological risk markers and its multi-level integration hold great promise regarding the prediction of SAD risk, maintenance and course, and in the future may allow for the selection of indicated preventive and innovative, personalized therapeutic interventions.

Authors & Co-authors:  Schiele Miriam A MA Bandelow Borwin B Baldwin David S DS Pini Stefano S Domschke Katharina K

Study Outcome 

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Citations : 
Authors :  5
Identifiers
Doi : 10.1016/j.euroneuro.2020.01.009
SSN : 1873-7862
Study Population
Male,Female
Mesh Terms
Anxiety, Separation
Other Terms
Anxiety disorders;CO(2) sensitivity;Genetics;Molecular;Panic disorder;Separation anxiety
Study Design
Narrative Study,Cross Sectional Study
Study Approach
Country of Study
Publication Country
Netherlands