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Genetic contributions to anxiety disorders: where we are and where we are heading

Published online by Cambridge University Press:  09 February 2021

Helga Ask
Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
Rosa Cheesman
PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
Eshim S. Jami
Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London, UK
Daniel F. Levey
Division of Human Genetics, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut Department of Psychiatry, Veterans Affairs Connecticut Healthcare Center, West Haven, Connecticut
Kirstin L. Purves
Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
Heike Weber
Department of Psychology, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
E-mail address:


Anxiety disorders are among the most common psychiatric disorders worldwide. They often onset early in life, with symptoms and consequences that can persist for decades. This makes anxiety disorders some of the most debilitating and costly disorders of our time. Although much is known about the synaptic and circuit mechanisms of fear and anxiety, research on the underlying genetics has lagged behind that of other psychiatric disorders. However, alongside the formation of the Psychiatric Genomic Consortium Anxiety workgroup, progress is rapidly advancing, offering opportunities for future research.

Here we review current knowledge about the genetics of anxiety across the lifespan from genetically informative designs (i.e. twin studies and molecular genetics). We include studies of specific anxiety disorders (e.g. panic disorder, generalised anxiety disorder) as well as those using dimensional measures of trait anxiety. We particularly address findings from large-scale genome-wide association studies and show how such discoveries may provide opportunities for translation into improved or new therapeutics for affected individuals. Finally, we describe how discoveries in anxiety genetics open the door to numerous new research possibilities, such as the investigation of specific gene–environment interactions and the disentangling of causal associations with related traits and disorders.

We discuss how the field of anxiety genetics is expected to move forward. In addition to the obvious need for larger sample sizes in genome-wide studies, we highlight the need for studies among young people, focusing on specific underlying dimensional traits or components of anxiety.

Special Issue Article
Copyright © The Author(s), 2021. Published by Cambridge University Press

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All authors contributed equally to this work.


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