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Can anxiety damage the brain?
Mah L, Szabuniewicz C, Fiocco AJ.. Current opinion in psychiatry, 2016-01-01
Topic: Risk, prevention and care in population studies
Purpose of review Stress exacerbates mental illnesses such as depression but also appears to increase risk of dementia, suggesting a common mechanism for development of stress-induced affective and cognitive impairment. The purpose of this review is to address the question of whether anxiety 'damages' the brain, and to identify potential mechanisms for the link between stress and neuropsychiatric illness. Recent findings Anxiety disorders are associated with alterations in fear neurocircuitry such that 'bottom-up' processes in the amygdala which respond to threat are exaggerated, and regulation of these processes by the prefrontal cortex (PFC) and hippocampus is impaired. Chronic stress exposure similarly alters fear neurocircuitry by enhancing amygdalar functioning while causing structural degeneration in the PFC and hippocampus thereby inhibiting PFC/hippocampus control over the stress response. Pharmacological (e.g., antidepressant medications) and nonpharmacological interventions (cognitive-behavioral therapy, exercise) may reverse stress-induced damage in the brain. Summary Pathological anxiety and chronic stress lead to structural degeneration and impaired functioning of the hippocampus and the PFC, which may account for the increased risk of developing neuropsychiatric disorders, including depression and dementia. Longitudinal studies are needed to determine whether reversal of stress-induced brain changes by interventions such as cognitive-behavioral therapy can reduce risk of neuropsychiatric illness.
Key findings
- Recent findings Anxiety disorders are associated with alterations in fear neurocircuitry such that 'bottom-up' processes in the amygdala which respond to threat are exaggerated, and regulation of these processes by the prefrontal cortex (PFC) and hippocampus is impaired.
- Summary Pathological anxiety and chronic stress lead to structural degeneration and impaired functioning of the hippocampus and the PFC, which may account for the increased risk of developing neuropsychiatric disorders, including depression and dementia.
Why it matters
Pathological anxiety and chronic stress lead to structural degeneration and impaired functioning of the hippocampus and prefrontal cortex, which may account for an increased risk of developing dementia. Pharmacological and nonpharmacological interventions may reverse stress-induced damage in the brain, but longitudinal studies are needed to determine whether reversal is possible.
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Study details
- Study designlongitudinal study
- Evidence strengthModerate
How this study scored 52/100
Published in a peer-reviewed journal, and it is a longitudinal study following the same people over time. Scored zero for sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Current opinion in psychiatry) |
| Journal's citation record | 1 / 4 | Current Opinion in Psychiatry: journal h-index 141 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A longitudinal study following the same people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2016 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 202 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 16.8 citations a year over 12 year(s) since 2016 |
| Impact for its field and year | 3 / 6 | Cited 4.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 2 other studies in this library |
| Still being cited | 3 / 4 | Cited 50 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Alexandra Jasmine Fiocco: h-index 33 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Toronto: institution h-index 1,923 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 26651008) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 52 / 100 | — |
What each of these 20 components measures, and what this score is not →
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Mah, L., Szabuniewicz, C., & Fiocco, A. J. (2016). Can anxiety damage the brain? Current opinion in psychiatry. https://doi.org/10.1097/yco.0000000000000223
Vancouver
Mah L, Szabuniewicz C, Fiocco AJ. Can anxiety damage the brain? Current opinion in psychiatry. 2016. doi:10.1097/yco.0000000000000223. PMID: 26651008.
BibTeX
@article{mah2016-26651008,
author = {Mah, L. and Szabuniewicz, C. and Fiocco, A. J.},
title = {{Can anxiety damage the brain?}},
journal = {Current opinion in psychiatry},
year = {2016},
doi = {10.1097/yco.0000000000000223},
pmid = {26651008},
url = {https://doi.org/10.1097/yco.0000000000000223}
}
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