17 HAMD CGI - SI CGI - GI Pvnoos RS Goenjian A Tashjian M et al. Post - traumat

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1 Bromet E Dew MA. Review of psychiatric epidemiolonic research on disasters. Epidemion Rev Pvnoos RS Goenjian A Tashjian M et al. Post - traumat-. Galea S Nandi A Vlahov D. The epidemiology of post - ic stress reaction in children after 988 Aimenian earthquake traumatic stress disorder after disasters. Epidemiol Rev. in Amenia. Br J Psychiatry PTSD Martorell A Tsakanikos E Pereda A et al. Mental health Jones E Vermaas RH McCartney H et al. Flashbacks and post - traumatic stress disorder the genesis of a 20th - century in adults with mild and moderate intellectual disabilities the role of recent life events and traumatic experiences across the life span. J Nerv Ment Dis diagnosis. Br J Psychiatry Catherine So - kum. Trajectory of traumatic stress symptoms in the aftermath of extreme natural disaster A study of adult Thai survivors of the 2004 southeast Asian earthquake and tsunami. Journal of Nervous & Mental Disease Grinde B. Can the concept of discords help us find the causes of mental diseases Medical Hypotheses CCMD - 3 HAMD 7 HAMA mg - 20mg /d HAMD HAMA CGI CGI - SI CGI - GI 69 6 HAMD HAMA CGI - SI HAMD - 7 HAMA llyyz2006@ 26. com

2 CGI - SI P < % 63. 9% 0. 06% R A Efficacy of Escitalopram in the treatment of major depressive disorders with anxiety symptoms. WU Haishan CHANG Maihui LI Lehua et al. Mental Health Institute the Second Xiangya Hospital Central South University Changsha 400 China. Abstract Objective The objective of this study was to assess the efficacy and tolerability of escitalopram 0 to 20 mg /d for treating the patients of major depressive disorders with anxiety. Methods This is an open - label multicentre flexible - dose 0 ~ 20 mg /d and 6 weeks treatment clinical trial. Outpatients and inpatients were enrolled to accept escitalopram treatment for 6 weeks if they met with the CCMD - 3 criteria of depressive episode and had a baseline Hamilton Rating Scale for Depression HAMD score of 7 and a Hamilton Rating Scale for Anxiety HAMA score of 4. The efficacy was assessed with HAMD HAMA and CGI at the end of baseline and weeks after treatment while safety was estimated with adverse event rating scale laboratory and physical examination. Results The HAMD scores HAMA scores and CGI - SI scores had significant reduction during 6 weeks escitalopram treatment. The response rate and remission rate were 8. % and 63. 9% respectively. The adverse drug reactions such as nausea and other gastrointestinal discomfort were tolerated. Conclusion Escitalopram has positive effectiveness in major depressive with anxiety disorders. Key words Depression Anxiety Escitalopram Efficacy MDD CCMD - Ⅲ 3 8 ~ SSRIs HAMD 7 7 SSRIs HAMA 4 6 SSRIs S HT SSRIs 3 α ~ > 25% HAMD Ⅳ

3 7 3 6 P < mg 3 H mg /d % % ± 2. 7 HAMD HAMD < 50% 5 ~ ± HAMA ± mg /d CGI - SI ± HAMD 4 HAMD HAMD HAMD ± 2. HAMD P 2.. < HAMD HAMD HAMD HAMA HAMD P < / HAMD / CGI SI HAMD / GI HAMD P < = - / % 7 50% 8. % 63. 9% % ± HAMA HAMA HAMA HAMA ± % ± RBC WBC Hb PLT HAMA P U - Glu UPro U - RBC U - WBC < HAMA ALT AST Cr BUN HAMA 2. 2 HAMA SPSS7. 0 x 珋 ± SD P < Wilcoxon

4 HAMD week 2week 4week 6week HAMD SD ± ± ± ± ± HAMD - SD ± ± ± ± ± HAMD / SD ± ± ± ± ± P * * * * * HAMD - 7 P < HAMA week 2week 4week 6week HAMA SD ± ± ± ± ± HAMA - SD. 93 ± ± ± ± ± HAMA SD ± ± ± ± ± HAMA SD ± ± ± ± ± P * * * * * HAMA P < CGI NEβ CGI CGI - SI ± ± ± ± ±. 5 CGI - GI CGI - SI P < P > % ~ % Zimmerman % SSRIs 5 - HT β 5 - HT 5 - HT HT HT NE HT

5 HT 4. β β2 5 - HT HT De Nayer A Geerts S Ruelens L et al. Venlafaxine compared with fluoxetine in outpatients with depression and con- 5 - HT 5 - HT comitant anxiety. Int J Neuropsychopharmacol Dunner DL Goldstein DJ Mallinckrodt C et al. Duloxetine in treatment of anxiety symptoms associated with depression. HAMD HAMA CGI - S Depress Anxiety Belzer K Schneier FR. Comorbidity of anxiety and depressive disorder Issues in conceptualization assessment and treatment. J Psychiatr Pract Pollack MH. Optimizing pharmacotherapy of generalized anxiety disorder to achieve remission. J Clin Psychiatry PD 9. Blanco C Antia SX Liebowitz MR. Pharmacotherapy of social anxiety disorder. Biol Psychiatry GAD Benfield PN. Citalopram A review of its pharmacology clinical efficacy and toterability in the treatment of depression. 2 3 GAD CNS Drugs mg /d. Stahl SM Gergel I Li D. Escitalopram in the treatment of 40mg /d 4 panic disorder A randomized double - blind placebo Goodman WK Bose A Wang Q. Treatment of generalized anxiety disorder with escitalopram Pooled results from doubleblind placebo - controlled trials. J Affect Disord Nutt D. Management of patients with depression associated with anxiety symptoms. Clin Psychiatry supp Owens MJ Knight DL Nemeroff CB. Second - generation SS- RIs human monoamine transporter binding profile of escitalopram and R - fluoxetine. Biol Psychiatry Mmerman M. Frequency of anxiety disorders in psychiatric outpatients with major depressive disorder. Am J Psychiatry controlled trial. J Clin Psychiatry Kasper S Stein DJ Loft H et al. Escitalopram in the treatment of social anxiety disorder randomised placebo - controlled flexible - dosage study. Br J Psychiatry Chauvet - Gelinier JC. Efficacy of escitalopram vs paroxetine on severe depression with associated anxiety data from the " Boulenger" study. Encephale