This review provides a broad overview of the state of research in the genetics of the major anxiety disorders (ADs). Overall, genetic epidemiological studies support a moderate level of familial aggregation (odds ratio: 4–6) and heritability estimates are about 30–50%. Twin studies suggest that the genetic architecture of ADs is not isomorphic with their classifications, sharing risk factors with each other and related phenotypes such as depression and anxious personality traits. Linkage and association studies of ADs have produced inconclusive results. Recently, genome-wide association studies with larger samples have been conducted to identify susceptibility genes for ADs. Animal studies provide a promising complimentary approach to human studies, since animal models for anxiety phenotypes are among the best validated across psychiatry. Gene environmental interaction and epigenetic studies may be important fields in the future research of genetics of ADs.

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Conditioned fear memory is critical for behavioral adaptation to the environment surrounding an individual. It is widely accepted that this implicit memory and its abnormal control are involved in the pathogenesis of anxiety disorders in which fear is a contributory factor. Identification of the biological system that plays a modulatory role in conditioned fear memory is fundamental to understanding the adjustment of these memory processes. In this brief review, we introduced recent findings of ours and other researchers on the control of conditioned fear memory. It is expected that elucidation of the control mechanisms aids in developing new treatment for anxiety disorders.

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Anxiety symptoms are frequently seen in palliative care settings. Clinicians have to judge whether and how they intervene with patients' and family's anxiety, depending on severity and time course of the symptoms. Severity of anxiety should be evaluated according to the level of patients' distress and the level of their functional impairment. There are sufficient amount of evidence that support effectiveness of psychotherapy. Also, use of pharmacotherapies are widely practiced, despite there is still room for further studies. It is an art of clinician's skills how to tailor treatment strategies that are allied with patients' goals and expectations.

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Sleep habits such as shortage of sleep and irregular bed time may be associated with the development and exacerbation of panic attacks, according to clinical impressions. The association remains to be further studied. The present study examined relationship between panic attack and sleep habits in adolescents using self-report questionnaire. Participants comprised Japanese students (N=699) at grades 7–12 from a secondary school in Tokyo. They were required to answer questions on sleep habits, panic attack and mental status (i.e., 12-item General Health Questionnaire). Panic attacks were experienced in 22.7% of the students, according to the questionnaire. The frequency was not different by sex or grade. Watching TV and using internet after midnight was significantly associated with the experience of panic attack after adjusting for grade, sex and depression/anxiety.

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The author, who suffere from autism spectrum disorder (ASD), has been engaging in peer support for adults with ASD and in support for academic and leisure activities in children with ASD. This paper discusses issues around anxiety disorders of children with ASD, which is of significance for school health staff and mental health professionals. Three cases of ASD subjects are described, two of whom were supported in the peer support activity and the other is the author himself. One of the significant issues may be that children with ASD have difficulties in recognizing their own anxiety. A special clinical approach is discussed which may help and be required in the treatment of the anxiety disorders in ASD subjects. Sensory difficulties in ASD children is focused on and taken into account in the approach.

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[in Japanese]

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