Oxytocin and Anxiety Disorders

  • Michael G. Gottschalk
  • Katharina Domschke
Part of the Current Topics in Behavioral Neurosciences book series (CTBN, volume 35)


In the present chapter, we review the literature focusing on oxytocin (OT)-centered research in anxiety spectrum conditions, comprising separation anxiety disorder, specific phobias, social anxiety disorder (SAD), panic disorder, generalized anxiety disorder, and anxiety-related endophenotypes (e.g., trust behavior, behavioral inhibition, neuroticism, and state/trait anxiety). OT receptor gene (OXTR) polymorphisms have been implicated in gene–environment interactions with attachment style and childhood maltreatment and to influence clinical outcomes, including SAD intensity and limbic responsiveness. Epigenetic OXTR DNA methylation patterns have emerged as a link between categorical, dimensional, neuroendocrinological, and neuroimaging SAD correlates, highlighting them as potential peripheral surrogates of the central oxytocinergic tone. A pathophysiological framework of OT integrating the dynamic nature of epigenetic biomarkers and the summarized genetic and peripheral evidence is proposed. Finally, we emphasize opportunities and challenges of OT as a key network node of social interaction and fear learning in social contexts. In conjunction with multi-level investigations incorporating a dimensional understanding of social affiliation and avoidance in anxiety spectrum disorders, these concepts will help to promote research for diagnostic, state, and treatment response biomarkers of the OT system, advancing towards indicated preventive interventions and personalized treatment approaches.


Amygdala Anxiety disorder Epigenetic Fear extinction Generalized anxiety disorder Genetic Imaging genetics Intranasal oxytocin Neuroticism OXT OXTR Oxytocin Oxytocin receptor Panic disorder Separation anxiety disorder Social anxiety disorder Social phobia Specific phobia Therapy genetics Trait anxiety Treatment response 



Serotonin transporter gene length polymorphic region


Cholecystokinin tetrapeptide




Childhood Trauma Questionnaire


Depression Anxiety and Stress Scale


Functional magnetic resonance imaging


Harm avoidance


Karolinska Scales of Personality


Major depressive disorder




Oxytocin/neurophysin I prepropeptide gene


Oxytocin receptor gene


Social anxiety disorder


Solute carrier family 6 member 4 (serotonin transporter) gene


State-Trait Anxiety Inventory


Trier Social Stress Test



This work was supported by the German Research Foundation (DFG) (SFB-TRR-58, projects C02 and Z02 to KD) and the Federal Ministry of Education and Research (BMBF, 01EE1402A, PROTECT-AD, P5 to KD).


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© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental HealthUniversity of WürzburgWürzburgGermany
  2. 2.Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of MedicineUniversity of FreiburgFreiburg im BreisgauGermany

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