Life events in panic disorder-an update on "candidate stressors"

Depress Anxiety. 2010 Aug;27(8):716-30. doi: 10.1002/da.20667.

Abstract

Studies on gene-environment interactions in mental disorders are characterized by powerful genetic techniques and well defined "candidate genes," whereas a definition of "candidate stressors," in most cases assessed in the form of life events (LEs), is inconsistent or not even provided. This review addresses this problem, with particular attention to the clinical phenotype of panic disorder (PD), by providing an overview and critical discussion for which life events are known to contribute to the etiology of the disease and how they may be conceptualized. There is converging evidence for a significant impact of cumulative as well as specific life events, such as threat, interpersonal and health-related events in adulthood, and abuse or loss/separation experiences in childhood, respectively, on the pathogenesis of panic disorder with some overlapping effect across the anxiety disorder spectrum as well as on comorbid major depression. Besides genetic vulnerability factors, personality and behavioral characteristics, such as anxiety sensitivity, neuroticism, and cognitive appraisal might moderate the influence of LEs on the development of panic disorder. The present state of knowledge regarding the specification and conceptualization of LEs in PD within a more complex multifactorial model, involving mediating and moderating factors in between genes and the clinical phenotype, is hoped to aid in informing future gene-environment interaction studies in panic disorder.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Age of Onset
  • Agoraphobia / diagnosis
  • Agoraphobia / genetics
  • Agoraphobia / psychology
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / genetics
  • Anxiety Disorders / psychology
  • Child
  • Child, Preschool
  • Comorbidity
  • Depressive Disorder, Major / diagnosis
  • Depressive Disorder, Major / genetics
  • Depressive Disorder, Major / psychology
  • Epigenesis, Genetic / genetics
  • Female
  • Genetic Association Studies
  • Genetic Predisposition to Disease / genetics
  • Genetic Predisposition to Disease / psychology
  • Humans
  • Infant
  • Life Change Events*
  • Male
  • Panic Disorder / diagnosis
  • Panic Disorder / genetics*
  • Panic Disorder / psychology*
  • Phenotype
  • Risk Factors
  • Social Environment*
  • Young Adult