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| 1 | Treating comorbid anxiety and depression: Psychosocial and pharmacological approaches显示文摘Comorbid anxiety with depression predicts poor outcomes with a higher percentage of treatment resistance than either disorder occurring alone. Overlap of anxiety and depression complicates diagnosis and renders treatment challenging. A vital step in treatment of such comorbidity is careful and comprehensive diagnostic assessment. We attempt to explain various psychosocial and pharmacological approaches for treatment of comorbid anxiety and depression. For the psychosocial component, we focus only on generalized anxiety disorder based on the following theoretical models:(1) 'the avoidance model';(2) 'the intolerance of uncertainty model';(3) 'the meta-cognitive model';(4) 'the emotion dysregulation model'; and(5) 'the acceptance based model'. For depression, the following theoretical models are explicated:(1) 'the cognitive model';(2) 'the behavioral activation model'; and(3) 'the interpersonal model'. Integration of these approaches is suggested. The treatment of comorbid anxiety and depression necessitates specific psychopharmacological adjustments as compared to treating either condition alone. Serotonin reuptake inhibitors are considered first-line treatment in uncomplicated depression comorbid with a spectrum of anxiety disorders. Short-acting benzodiazepines(BZDs) are an important 'bridging strategy' to address an acute anxiety component. In patients with comorbid substance abuse, avoidance of BZDs is recommended and we advise using an atypical antipsychotic in lieu of BZDs. For mixed anxiety and depression comorbid with bipolar disorder, we recommend augmentation of an antidepressant with either lamotrigine or an atypical agent. Combination and augmentation therapies in the treatment of comorbid conditions vis-à-vis monotherapy may be necessary for positive outcomes. Combination therapy with tricyclic antidepressants, gabapentin and selective serotonin/norepinephrine reuptake inhibitors(e.g., duloxetine) are specifically useful for comorbid chronic pain syndromes. Aripiprazole, quetiapine, risperidone and other novel atypical agents may be effective as augmentations. For treatment-resistant patients, we recommend a 'stacking approach' not dissimilar from treatment of hypertension In conclusion, we delineate a comprehensive approach comprising integration of various psychosocial approaches and incremental pharmacological interventions entailing bridging strategies, augmentation therapies and ultimately stacking approaches towards effectively treating comorbid anxiety and depression. | Jeremy D Coplan Cindy J Aaronson Venkatesh Panthangi Younsuk Kim | 2015 | World Journal of Psychiatry2015，5，4： | 7 |
| 2 | A road map for those who don't know JAK-STAT显示文摘 | Aaronson D S Horvath C M | 2002 | Science2002，296，5573： | 1 |
| 3 | The right ventricular failure risk score a pre-operative tool for assessing the risk of right ventricular failure in left ventricular assist device candidates显示文摘 | Matthews JC Koelling TM Pagani D Aaronson KD | 2008 | J Am Coll Cardiol2008，51，： | 1 |
| 4 | A road map for those who don't know JAK-STAT 显示文摘 | Aaronson D S Horvath C M | 2002 | Science2002，296，5573： | 1 |
| 5 | In vitro cultivation of human tumors:establishment of cell lines derived from a series of solid tumors显示文摘 | GIARD D J AARONSON S A TODARO G J | 1973 | Journal of the National Cancer Institute1973，51，5： | 1 |
| 6 | A road map for those who don't know JAK-STAT显示文摘 | Aaronson D S Horvath C M | | 0，，5573： | 1 |
| 7 | Improved Simulation of Stabilizer Circuits 显示文摘 | AARONSON S GOTTESMAN D | 2004 | Phys Rev A2004，70，05： | 1 |
| 8 | national statistics on penile fracture显示文摘 | Aaronson D S Shindel A W | 2010 | J Sex Med2010，7，9： | 1 |
| 9 | Teachers and student achievement in the Chicago public high schools 显示文摘 | Aaronson D Barrowl Sander W | 2007 | Journal of Labor Economics2007，25，1： | 1 |
| 10 | A road map for those who don' t know JAK-STAT显示文摘 | Aaronson D S Horvath C M | 2002 | Science2002，296，： | 1 |
| 11 | Quality of life of early-stage breast cancer patients treated with radicalmastectomy or breast-conserving procedures results of EORTC Trial 10801显示文摘 | Curran D van Dongen P Aaronson NK | 1998 | Eur J Cancer1998，34，3： | 1 |
| 12 | A placebo- and active-controlled randomized trial of prophylactic treatment of seasonal aller-gic rhinitis with mometasoue furoate aqueous nasal spray 显示文摘 | Graft D Aaronson D Chervinsky P | 1996 | JAllergy Clin Immunol1996，98，4： | 1 |
| 13 | Quality of life in breast cancer patients aged over 70 years, participating in the EORTC 10850 randomized clinical trial 显示文摘 | De Haes JC Curran D Aaronson NK | 2003 | Eur J Cancer2003，39，7： | 1 |
| 14 | Development and prospective validation of a clinical index to predict survival in ambulatory, patients for cardiac transplant evaluation 显示文摘 | Aaronson K D Schwartz J S ChenT M | 1997 | Circulation1997，95，12： | 1 |
| 15 | Meta-analysis: does lido- caine gel before flexible cystoscopy provide pain relief 显示文摘 | Aaronson D S Walsh T J Smith J F | 2009 | BJU Int2009，104，4： | 1 |
| 16 | Growth in worker quality 显示文摘 | Aaronson D Sullivan D G | 2001 | Economic Perspectives2001，，4： | 1 |
| 17 | Physical exercise in cancer patients during and after medical treat- ment:A systematic review of randomized and controlled clinical trials显示文摘 | Knols R Aaronson N K Uebelhart D | 2005 | J Clin Oncol2005，23，16： | 1 |
| 18 | National in- cidence and outcomes of postoperative urinary reten- tion in the Surgical Care Improvement Project显示文摘 | Wu A K Auerbach A D Aaronson D S | 2012 | Am J Surg2012，204，2： | 1 |
| 19 | In vitro cultivation of human tumors : establishment of cell lines derived from a series of solid tumors显示文摘 | GIARD D J AARONSON S A TODARO G J | 1973 | J Natl Cancer Inst1973，51，5： | 1 |
| 20 | Physical exercise in cancer patients during and after medical treatment: A systematic review of randomized and controlled clinical trials 显示文摘 | Knols R Aaronson NK Uebelhart D | 2005 | JClinOncol2005，23，： | 1 |
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