1 140 ( ) ( ) ( ) ( ) ( ) ( )
2 140 ( ) (2002-2010 ) ( ) (15 45 ) (IPAP) ( ) - - - - 12 50
3 140 1 (Schizophrenia) 2 2.1 3.8 8.4 13 0.22 2 3 1982 12 5.69 (1985 ) 1994 12 6.55 (1998 ) 15 7.11 4.26 1978 4 369 448 l 579 315 1.8 1.67 1987 ( ) 4.4 ( 4.0 4.8 ) 1994 3 1996 4 510 156 81 75 30.6 354 69.4 9.6 31 1 17.9 2 3 2.2 2.2.1 (1) (2)20 70 (3)20 80 1986
4 140 1991 2001 2.2.2 21 1994 82.7 53.5 14.7 (CBR) CBR 2.2.3 3 3.1 3.1.1 4 14 10.40 3 (1974) 6 73 2.1 12.3 5 11 2l 8 19 x 6 13 22
5 140 3.1.2 20 ( ) CT MRI CT MRI Schulsinger (2001) 166 O'Callaghan(1991) 1957 2 3 Htuttunen (1994) 1957 2 Roberts(1991) (Travis 1977)
6 140 3.1.3 3.1.3.1 3.1.3.2 NK 3.2 3.2.1 50 60 3.2.2 Liem (1981) 3.2.3 ( ) 12 10.2 7.5 25.4 (4.6 ) (2.9 6.9 ) 1985 Eaton 17 15 - (Hare 1956)
7 140 3.2.4 Wmg 20 70 zu-lim. Paykel (1978) 6 1 3.3 3.3.1 D2 (Am-phetamme) 20 Dl D1 20 3.3.2 (PCP) 3.3.3 5 - LSD-25 5-HT 1954 10 DA 5-HT2A 5-HT2A DA 5-HT 5-HT DA 5-HT 3.3.4 (Ach) (DA) (MAO) MAo Y
8 140 4 4.1 4.1.1 ( ) (1) (2) ( ) (3) (4) (5) (6) (7) 4.1.2 4.1.3 4.1.3.1 (1) (2) (3) (4) 4.1.3.2
9 140 (1) (2) 30 1 (3) (4) (5) ( ) (6) (7) (8) (9) 4.1.3.3 4.1.3.3.1 a. (1) (2) (3) ( ) b. (1) (2) 1) 2) 3), (3) (4)
10 140 (5) (6) c. d. 4.1.3.3.2 (1) 1) 2) 3) (2) (3) (4) 4.1.3.4 4.2 4.2.1 30 4.2.1.1 Yung McGorry Huber 3
11 140 ( ) 4.2.1.2 4.2.1.2.1 (1) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) (2) ( ) ( ) 4.2.1.2.2 ( ) ( ) 4.2.1 2 3
12 140 4.2.1 2 4 ( ) ( ) 4.2.1.3 4.2.1.3.1 (1) ( ) 30 (2) (3) (4) ( ) CCMD-3 4.2.1.3.2 20 80 crow I ( ) ( ) 1-1 I Crow
13 140 1-1 I I ( ) 4.2.1.3.3 5 4.2.2 1 5 50 10 75 5 80 5 60 4.3 4.3.1CCMD-3 4.3.1.1 2 (1) (2) (3) (4) (5) ( ) (6) (7) (8) (9) 4.3.1.2 4.3.1.3.
14 140 (1) 1 (2) 2 4.3.1.4 CCMD-3 20.1 [F20.0] 20.2 ( ) [F20.1] 20.3 [F20.2] 20.4 [F20.6] (1) (2) (3) 2 20.5 [F20 3] (1) (2) 20 6 [F2018 F20.9] 20.9l 20.92 4 20.x1 [20.4] (1) 1 (2) 2 (3) 20.x2 [F20 X5 ] 2 20.X3 [1720.x4 ] (1) 2 (2) l 1) 2) 3) (3) (4) 1 20 x4 [R0 X8 ] (1) (2) 2 20 X5 [F20.X8 ] (1)
15 140 (2) 1 4.3.2 ICD-10 4.3.2.1 (1) (4) ( ) (5) (9) (1) (2) (3) (4) ( ) (5) (6) (7) (8) (9) 4.3.2.2 4.3.2.3 1 4.3.2.4 ( 3 ) (1) (2) (3) 4.3.3 DSM 4.3.3.1 1 ( 1 ) (1) (2) (3) ( ) (4) (5) 2 1 4.3.3.2 ( ) ( ) 4.3.3.3 6 6 1 A ( ) ( 1 ) A 2 2 ( )
16 140 4.3.3.4 4.3.3.5 ( ) 4.3.3.6 1 ( 1 ) 4.4 4.4.1 DSM- (SCID) ICD-10 DSM- (CIDI) CCMD-3 ICD-l0 DSM- (RTHD) RTHD RTHD (RTHD-P) RTHD (RTHD-c) RTHD (RTHD-R) 4.4.2 4.4.2.1 (BPRS) BPRS 1962 18 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18 7 19 20 BPRS 4.4.2.2 (PANSS) (PANSS) PANSS I PANSS 7 7 16 30 3 30 50 PANSS 7 1. 2 3. 4. 5. 6 7. 1
17 140 2 P1 P2. ( ) P3. P4. P5. P6. P7. N1. N2. N3.( ) N4. N5 N6. N7. G1. G2 G3. G4. G5. G6. G7. G8 G9 G10. G11. G12. G13. G14 G15. G16. PANSS PANSS BPRS 5 5.1 5.1.1 (1) (2) (3) (4) 5.1.2 ( ) (1) (2) (3) (4) (5) 5.1.3 ( ) (1) (2) (3) (4) 5.2 5.2.1 5.2.1.1 EKG ( ) 4 6
18 140 ( ) ( ) ( ) 5.2.1.2 ( ) 3 6 5.2.1.3 2 5 5.2.2 ( ) 5.2.3 5 ( ) ( ) ( ) 2 5 5.3 5.3.1 (1)
19 140 6 8 ( 1.2) 1-2 (mg d) (mg d) 25 50 150 200 5~10 20 25 50 300 600 2 4 10--20 4 6 20 60 100 200 800 1000 100--200 600--1400 25 50 200--600 25--50 200--600 1--2 4 6 5--10 10 20 50 100 400--750 200 400 800 1200 100 200 400--1000 ( ) 750 1000 6 10 10--20 20mg w 50--200mg m 12.5-50mg 2-3w 200mg 2-3w 20--40mg 2-3w 500 100mg 2w (2) 1) EPS 2) ( ) 3)
20 140 EPS. (3) (4) (5) (6) (WPA) ( ) (EPS ) 5.3.2 5.3.2.1 ( ) D1 ( ) 20 50 5.3.2.1.1 D2 D2 1 2 M1 H1 Tourette Huntington 5.3.2.1.2 (1) ((Chlorpromazine) 2 4 l0 33 98 8 35 200 600 mg d 400 mg d 200 mg d 6 8 (2) (Perphenazine) 1 4 25 90 3 5 P450 CYP 2D6 8 21 D2
21 140 4 6 mg d 20 60 mg d (3) (haloperidone) 1958 40 70 92 3 5 15 25 D2 6 20 mg d 2 6 mg d (4) (Sulpiride) 3 8, 8 D2 DA DA EPS 200 600 mg d 1 000 mg d 200 600 mg d 1 2 GPT (5) 3 (Penfharidol) 65 70 50 200 mg m( ) 12.5 50 mg 2 3 w( ) 20 40 mg 2 3 w( ) 50 100 mg 2 w( ) 20 80 mg w( ) ( ) 5.3.2.1.3 (1) (2) (3) 30 (4) (5) (6) 5.3.2.2 ( ) 5-HT2 (DA)-5-HT (SDAs)
22 140 EPS 5.3.2.2.1 (Clceapine) (1) 1958 1972 1975 1 600 16 ( 1 600 mm3) 13 8 50 20 80 1990 FDA 2 27 47 12 94 45 350 ng ml 250 ng ml 6 350 ng ml 80 5 5-HT2A 5-HT2C D2 5-HT2 5-HT2A D2 5-HT2 5-HT 1-2- Hl M1 - (2) : (25 75 mg d) 200 600 mg d (3) 2 10 (4) 2 g 12 40 3-4 g 12 (5) P450
23 140 CYP l 2 SSRIs CYP 1 2 2D6 CYP 2C 3A4 ( 50 ) CYP 2D6 (6) 5 14 D4 5-HT GABA 5.3.2.2 2 (Risperidone) (1) FDA SDAs 1994 1997 70 82 CYP 2D6 9-9- 1 9-3 88 3 9-24 5-HT 5-HT2A D2 D2 l- 2- - (2) 2 6mg d (3) 45 1 mg 500 29 245 mg (4) CYP 2D6 5.3.2.2.3 (Olanzapine) (1) 1982 Eli Lilly 1995 7 1996 1999 5 31 (21 54 ) 1
24 140 93 CYP 1 2 CYP2D6 5-HT2A D2 D1 D4 (M1) H1 5-HT2C 5-HT3 1 5-HT 8 D2 (PCP) PCP N- -D- (NMDA) (2) 5 20 mg d (3) 230 43 600 mg 1 238 ug L 6 987 ug L 490 mg dl 4 100 mg dl 72 6 12 237 mg L 675 mg L 197mg L 17400 mg L l 30 40 mg (4) (>25 ) CYP 3A (50 ) 5.3.2.2.4 (Quetiapine) (1) SDAs Zeneca 1996 2001 1 1 5 83 6.9 48 95 1 30.50 5-HT2 Hl 5-HT6 1 2 D2 - D1 M1 D4 ( ) QTc
25 140 (2) 300 750 mg d (3) 20 g QTc QTc 2 3 26 10 000 mg 2 3 4 mm 135 70mmHg 16 18 40 12 18 (4) CYP 3A4 CYP 2D6 CYP 1 2 3C92C19 3A4 CYP 3A4 5 ( ) 60 5.3.3 20 50 WPA ( ) ( ) 50 60 ( 1.3)
26 140 1.3 CNS EPS 0 ++ 0 + 0 + 0 TD +++ 0 +?? 0 + +++ 0 + + + +++ +++ + + + + + + +? + +++ 0 +++(?) + + 0 Q-Tc 0 ++ 0 0 + 0 0 + 0 ++ 0 + 0 + 0 + 0 + 0 +++ +++ 0 + 0 + +++ 0 0 0 ++ +++ 0 + ++ 0 + 0 0~+ 0 0 0 0 0 ++ +++ ++ ++ ++ 0 + 0 + 0 + 0 + 0 + [1]CNS [2]EPs [3]TD 5.3.3.1 5.3.3.1.1 10 H1 5.3.3.1.2-5.3.3.1.3 64.3 P (0.1 mg 0.2 mg 1 ) 5 3.3.1.4 80
27 140 ( ) B 5.3.3.1.5 ( ) DA DA 5.3.3.1.6 ( ) 3 10 1 2 38.5 28 5.3.3.1.7 5.3.3.1.8 5-HT2C H1 2 5.3.3.1.9 (ALT) 5.3.3.1.10 ( ST-T T Q-T ) ( - ) 3.3 4.9
28 140 QTc B ( ) 1 3 000 4 000 12.5mg 36 4 5.3.3.2 5.3.3.2.1 (Neuroleptic Malignant Syndrome NMS) NMS 0.12 0.2 O.07 1.4 =2 1 NMS DA NMS ( 41 42 ) ( ) 7 20 30 DA DA (5 mg 4 1 ) ECT 5.3.3.2 2 (300 mg d 1 2 300 600 mg d 3 4 600 900 mg d 5 ) 500 mg d 600 mg d. 5.3.3.2.3 10 1 2 0.73 0.07 6--18
29 140 2.32 0.69 1--2 6 2 4 ( ) 18 3 500 mm3 3 000 mm3 1 500 mm3 2 2 000 mm3 1 000 mm3 2--3 N- E C ( ) 5.3.3 2.4 - (Adarns-stokes syndrome) 0.5 ATP K+ ( ) 5.3.3.3 5.3.3.4 EPS CNS ECG (DIC)
30 140 1 5 000 5 10 kg 50mg 5 10 100 200mL 30 50 mg 5.4 5.4.1 75 5.4.2 5.4.2.1 5.4.2.2
31 140 ( ) 5.4.2.3 - - ( ) 5.4.3 5.4.3.1 5.4.3.2 ( ). 5.4.3.3
32 140 5.4.3.4 (1) (2) 5 10 (3) (4)
33 140 1 2 1 (5) 5.4.3.5 ( ) 5.4.3.6 1 2
34 140 5.4.3.7 ( ) ( ) 5.5 (cther physical trealrnmt) 20 30 50 E 5.5.1 (electroconvulsive therapy ECT) ECT 20 30 Muduna 3 1 26 10 3 13 1938 Cerletti Bini ECT 5.5.1.1 ECT ( ) 5.5.1.2 ECT 5.5.1.3 ECT ECT ( ) (4 8 ) ECT ECT ECT ECT ECT ECT
35 140 (1) 0.5 mg (2) 1 (1.0 2.5 mg kg) (3) 0.2 (0.5 1 5 mg kg) (4) (5) (110 mv)3 30 40 ECT 5.5.2 (insulin coma thetrapy ICT) 1933 Sakel ICT ICT 30 15 50 60 1962 Aekner Oldham 20 80 5.5.3 (psychosurgery treatment) 1935 Jacclbsen Egas Moniz 20 1936 Freeman Watts Moniz Freeman Warts 20 40 5 000 1949 Moniz 20 40 10 CT MRI Min&Js(1988) 300 70 Ballantine (1990) 198 9 66 4 6 6 6.1 6.1.1 6.1.1.1
36 140 [ ] (1) ( 1 2) 1 2 7 10 (2) 1) l 2 6 8 ( 5.3.1 (2)) 2) 3) * ECT 6.1.1.2
37 140 [ ] 1) 2) 3) * ECT 6.1.1.3 [ ] 1) 3 5 (200 600 mg d) 1 2
38 140 2) 3) * ECT 6.1.1.4 [ ] 1) 2) 6.1.1.5 (1) [ ] 1) 2) (SSRIs SNRIs NaSSa
39 140 TCAs) 3) * ECT (2) [ ] 1) 2) 3) * ECT 6.1.2 6.2 ( ) 3 6 6 1 1 2 6.3 3 ( 6 ) 1-2 ( ) 6.4.
40 140 [ ] ( I ) 6.5 [1]EPS [2]NMS- [3]TD [4] - - [ ].(1)EPS EPS (2) - (3)NMS DA DA (5 mg
41 140 4 1 ) ECT NMS (4) TD r- (GABA) TD TD TD (5) 3 000 mm3 1 500 mm3 2 2 000 mm3 1 000 mm3 2 3 6.6 [1] [2] BZDs- [3] [4] SSRIs [ ] (1) BZDs (2) BZDs (3) SSRIs (4) SSRls
42 140 6.7 [ ] (1) DA (2) 6.8 [ ] 50 mg 5 10 100 200 ml 30 50 mg 2
43 140 7 7.1 ( ) 7.1.1 7.1.1.1 7.1.1.2 1 4 1 3 1 2 1-4 1-4 (mg d) 10 300 10 300 ECG 2 6 4 32 4 20 0.25~6 10 20mg w 300 450 5 100 0.5 2.5 2.5 20 50 400 ( ) (FD) Daividson(1989) 2.5 mg(0.1 ml) 1 2 FD (HD) 5 mg 1 2
44 140 7.1.1.3 (TD) TD (Philip 1991) TD 10 20 (Hader 1965) 7.1.2 7.1.3 7.1.4 7.2 1 5 l-5 (mg) ( ) ( ) 10 200 2 4 2 20 1 2 0.25 16 1 2 l 20(6 ) 1 2 10 200 2--4 0.5 16 1~2 10 200(6 ) 1 2 100 600 2 3 1 4 l 2 2.5 20 l 2 7.2.1
45 140 2 3 4 6 7.2.2 7.2.3 7.2.4 Eggers(1978) 57 20 20 30 50 104 26.9 26.9 16.2 30 70 53.8 ( ) 7.3 20 2.4 2 1 3 4 1 2 1 10 kg ( 3.1 1.4) (1)
46 140 (2) (3) 12 (4) ( 1 2 1 3) 7.4 7.5 Kreapelin 20 70 60. 5-HT Harrow M (1994) Subotnik(1997) Smith (1997) 7.5.1 7.5.1.1 7.5.1.2 Viala (1996) (20 40 mg d) 2 Spina(1994) 34 HAMD Goff(1995) EPS SSRIs 7.5.1.3
47 140 7.5.1.4 17 7.5.2 ( ) 7.6 9 24 350 600 10 50 Drake (1989) 7.6.1 ECT 20 40 70 Meltzer Okayli(1995) 88 7.6.2 Drake (1989) 7.7 7.7.1 EKG 7.7.2 7.7.3 7.7.4 2
48 140 7.8 7.8.1 EPS 7.8.2 EPS EPS 7.8.3 P450 7.8.4 7.8.4.1 (MAOIs) 7.8.4.2 P450.. 7.8.4.3 5. (SSRIs) 7.8.4.4 8 8.1 ( ) 8.1.1 8.1.1.1 (handicap ) (impair-ment) (disability) (normal role) 8.1.1.2 ( )
49 140 8.1.2 8.1.2.1 (Rehabiliation) ( ) 8.1.2.2 8.1.3 1987 ( ) 78.75 8.1.4 8.1.4.1 8.1.4.2 (1) (2) (3) (4) (5) 8.1.4.3 (1) 1) (PSE) (SANS) Wing
50 140 2) (TD) 3) WHO (SDSS) 10 1 0 2 (0 1 2 ) ( ) 3 3 2 ( ) 2 ( ) 2 ( ) 2 2 1 1 0 1994 SDSS (NOSIE) (SDSI ) Momingside (2) (3) (4) ( ) (5) 8.1.5 8.1.5.1 8.1.5.2 P.R.Liberman 8 1.5.2.1 (1) Bulter (2) (3)
51 140 1) ( ) 2) 3) (4) 8.1.5.3 (communityhased rehabmtation,cbr) 8.2 8.2.1 8.2.1.1 (1) (2) (3) (4) (5) 8.2.1.2 8.2.2 ( ) 8.2.2.1 8.2.2.2 8.2.2.3
52 140 8.2.2.4 (night hospital) 8.2.2.5 (Half-way house) 8.2.2.6 (Psychosocial re-habilitation club) 8.2.2.7 ( ) (Sheltered workshop) 8.2.2.8 8.2.3 (HEE) (LEE) 8.2.3.1 8.2.3.2 8.2.4 (1)
53 140 (2) (3) (4) ( 8.1.5) (5) (6) (7) (8) (9) 9 (2002 2010 ) 10 9.1 (2002--2010 ) 1 2005 30 2010 50 6 2005 50 2010 60 9 2005 4 2010 8
54 140 9.2 (1) (2) (3) (4) (5) 9.3 (1) ( ) ( ) (2) (3) 9.4 9.4.1 (1) (2) 9.4.2 (1) (2) (3) 9.4.3 (1) (2)
55 140 (3) 9.5 9.6 (1) (2) (3) (4) 10 5 20 80 B1euer A Schneider ( ) ( ).
56 140 1 10 2 2.1 1984 (NIH) (epidemiologic catchmentarea ECA) 4.9 3.3 (Regier 1988) 1994 17.1 ( 12.7 21.3 ) 6 (Kessler 1998) (WHO,1993) 15 12.5 10 ( ) 38 000 1.5 19.0 0.8 5.8 (Myra,1996) 2.2 ( ) 20 80 ICD-9 DSM- WHO(1993) 4.0 0.6 1.5 (Myra 1996) ( 2 ) 23 3.86 5.07 2.61 (Chen 1999) 2.3 2.3.1 ( ) 16 25 11 2 3 15 25 90 93 50 70 83.3 10 (11.2 10 ) 8
57 140 22.2 10 (1993 ) 3 4 40 55 10 571 63 40 (Dhillips 2002) 2.3.2 WHO(1993) (GBD) 1990 2020 1990 5 AIDS 5 15 44 10 5 ( ) 17.3 15.9 (DALY) 4.2 5.9 2020 1990 2020 14.2 15.5 18.1 20.2 l 5 1 2 (20.2 ) 3 5 (1990 44 2020 47 ) (1994) 4 430 90 (28 ) 340 Kir Sorensen(1993) 30 88. 2.3.3 WHO 15 55.6 21 80 ( ) 3
58 140 3.1 3.1.1 12 24 2.5 12 38 69 95 31 12 40 70 3.1.2 2 1 3.1.3 ( ) ( ) 3.1.4 3.1.5 2 3 3.1.6 3.1.6.1 3.1.6.2 ( )
59 140 3.1.6.3 3.1.6.4 5 3.1.7 ( ) 50 3.1.8 ( ) ( ) ( ) ( ) ( ) ( ) 3.2 3.2.1 22.2 10 40 70
60 140 3.2.2 3.2.3 2.3.1 4 4.1 4.1.1 4.1.1.1 4.1.1.2 4.1.1.3 22 33 20 45 40 33 1 3 22 37 14 18 (Stevens 1995) 4.1.1.4 4.1.1.5 4.1.1.6 4.1.1.7 ( ) 4.1.1.8
61 140 4.1.2 ( ) 4.1.3 4.1.3.1 (Dexamethasone Suppression Test DST).. (HPA) ACTH 11 l mg 8 4 11 1 5 ug dl 45 4.1.3.2 (Thyrotropin-releasing Hormone Suppression Test TRHST) (TSH) 500 mg (TRH) 15 30 60 90 TSH TRH TSH l0 29 miu ml TRH ( 7mIU ml) 25 70 DST TRHST 4.1.4 4.1.4.1
62 140 ( ) ( ) 4.1.4.2 (open-ended) (dose-ended) ( ) 4.1.4.3 ( ) ( ) 4.1.4.3.1 ( depressed mood)
63 140 4.1.4.3.2 (decreased interest ) (lack of pleasure) ( ) 4.1 4 3.3 ( ) ( ) (helplessness) ( ) 4.1.4.3.4 4.1 4 3 5 4 1.4.3.6 4.1.4.3.7 4.1.4.3.8 ( ) 4.1 4.3.9
64 140 ( 2-1 Preskom 1999) 2-1? ( )?? 4.2 (CCMD-3) 32 [ ] 4 (1) (2) (3) (4) (5) (6) (7) (8) (9) [ ] [ ] (1) 2
65 140 (2) 2 [ ] 32.1 32 32.2 32 32.3 32 32.4 [ ] (1) 2 (2) (3) 32.4l 32.4 32.1 32.42 32.4 32 2 32.43 32.4 32.2 32.9 33 33.1 [ ] [ ] [ ] 2 2 [ ] (1) (2) 33.2 [ ] [ ] [ ] 2 2 2 [ ] (1) (2) 10 (ICD-10.WHO 1992) F32 ( )
66 140 (a) (b) (c) ( ) (d) (e) (f) (g) F32.0 2 F32.1 2 F32.2 2 F32.3 F33 F34 ( ) F34.0 F34.1 ( ) F38 F39
67 140 4.3 4.3.1 Zung (SDS) (HAMD) ( BDI HAMI)) (WHO) (CIDI) (1990) ICD 10 DSM I ( SCID-I)(Flrsl.et al 1996 ) DSM- (RTHD) CCMD-3 DSM- ICD-l0 3 4.3.2 (SDS) Zung(1968) (SDS) 20 4 SDS SDS 4.3.3 (HAMD) HAMD HAMD 21 17 17 21 24 HAMD 5 ( 0 4) 0 2 3 HAMD HAMD 17 HAMD 24 17 7 4.3.4 Montgomery-Asberg (MADS) Montgomery Asberg(1979) l0 0 6 7 HAMD 5 5.1 (1)
68 140 (HAMD 7) 13 (HAMD >50 ) 34 (2) (3) (>50 ) 5.2 5.2.1 60 80 (1) (2) (3) (4) ( ) (>4 6 ) (5) 5 MAOIs SSRIs 2 MAOIs 2 SSRIs (6) (7) (8) (9) - - (10) (11) SSRIs SNRIs NaSSAs TCAs 5.2.2 50 85 2 (1) ( ) (HAMD 7) (2) ( HAMD >50 ) ( ) (3) ( ) 5.2.2.1 2 4 10 20 6 8
69 140 5.2.2.2 4 6 5.2.2.3 WHO ( ) ( 5 ) 6 8 5 Goodwin Jamison 2 3 ( ) 5.2.3 20 (HCAs) (TCAs) ( ) 5-HT (SSRIs) 5-HT NE (SNPIs) NE DA (NDRIs) 5-HT2A 5-HT (SARIs) NE 5-HT (NaSSA) (RMAOI) TCAs 5.2.3.1 SSRIs 5-HT 5-HT 5-HT NE H1 MI 5-HT T1/2 20 h ( 7 15 ) 5 SSRIs 2-2 5-HT 2-3 2-2 5 5-HT (h) 4-8 3-8 6 8 2 8 1 6 ( ) 95 95 95 77 80 ( ) 50 50 50 50 50 T1/2(h) 24 72 20 25 15 35 T1/2(h) 7 15 -- 66 -- -- (d) 35 14 14 14 14 (d) 28 35 5 7 5 7 5 7 5 7 (L kg) 3 40 17 20 75 12 16 (ng ml) 100 300 30 100 25~50 250 60 + + + + T1/2-2D6 1A2 3A4
70 140 2C19 2-3 5 5-HT (mg) (mg/d) (mg/d) (ng/ml) 20 20 40 60 qd 100 300 20 20 40 60 qd 30 100 50 50 100 200 qd 25 50 50 100 200 300 qd bid 250 20 20 60 120 qd 60 (1) (2) SSRIs MAOIs SSRIs 1 4 (3) TCAs 5-5-HT SSRIs SSRIs 5-HT 5-HT 5-HT ( ) SSRIs 5-HT (4) SSRIs CYP(P450) CYP(P450) SSRIs SSRIs SSRIs SSRIs ( 2 4) 2.4 SSRIs CYP1A2 CPY2D6 CPY3A3/4 CYP2C19 * ( ) ( ) ( ) TCAs * 5.2.3.2 SNRIs 5-HT NE (Venlafaxine) ( ) ( Efexor XR) 5-HT NE M1 Hl al (1) 27
71 140 Tl/2 4 5 h P450 2D6 (2) (3) MAOIs 5-HT 5- (4) 75 mg d 75 300 mg d 150 200 mg d 2 3 ( ) 75 150 mg 75 300 mg d 1 (5) 5.2.3.3NaSSAs NE 5-HT NE 5-HT (Mirtazapine ) NE 5-HT 5-HT2 5-HT3 a2 H1 (1) 2 h T1/2 20 40 h 85 (2) (3).MAOIs 5-HT 5- (4) 30 mg d 45 mg d 1 (5) SSRI 5.2.3.4 TCAs (Imipramine) (Amitriptyline) (Doxepine) (Desipramine ) (Nortriptyline) (Maprotiline) TCAs TCAs 2 8 h 90 T1/2 30 48 h 5 14 NE 5-HT a1 H1 M1 (1) (2) 12 TCAs MAOIs (3) TCAs 50 250 mg d 5.2.3.5 SARIs 5-HT 5-HT2 5-HT1A 5-HT 5-HT
72 140 5.2.3.5.1 (Trazodone ) H1 a1 a2 a1 (1) 1 h 89 95 Tl/2 5 9 h 11.6 h 4 (2) (3) (4) 50 100 mg 1 3 4 50 mg 150 300 mg d T1/2 (5) (6) 5-HT 5-HT MAOIs 5.2.3.5.2 (Nefazodone) (1) 1 3 h 2 5 T1/2 18 h 99 (2) (3) 300 500 mg d (4) (5) CYP3A4 5.2.3.6 a2-5-htl 5-HT2 (Mianserin ) (1) 3 h 6 T1/2 32 h TCAs (2) (3) (4) 30 90 mg d 1 (5) 5.2.3.7 NDRIs NE DA 5-HT (Bupropior ) (1) 2 h 85 T1/2 l5 h (2) (3) MAOIs SSRIs (4) 150 450 mg d 3 150mg (5) 5.2.3.8
73 140 (Amoxapine ) NE 5-HT 7- D2 (1) 1 2 h T1/2 8 h 7-6.5 h (2) (3) (4) 100 400 mg d 50 mg d 3 (5) D2 5.2.3.9 MAOIs MAOIs MAOIs MAOIs (Moclobemide ) A l 2 h T1/2 l 2 h Tl/2 8 h 300 600 mg d 2 3 MAOIs SSRIs 2 5.2.3.10 (1) (Tianeptine) (Tatinol) 5-HT 5-HT 5-HT 5-HT 5-HT 5-HT ( ) 2.5 h 12.5 mg (37.5 mg d) 25 mg d (2) (Deanxit ) 0.5mg 10 mg 2 2 1 2 (3) (Saemesyl 1 methionine SAMe) (DA NE) (5-HT ) 400 800 mg 15 20 2 3 ( 400 mg) 4 (4) (Neurostan SWE LI 160) ( )
74 140 Hyperforin Hypencin Perforatum 5-HT NF DA 300 mg 3 2-5 2.5 (mg d) 5-HT SSRIs Fluoxetlne 20 60 MAOIs 2 Pamxetine 20 60 Sertraline 50--200 Flumxamlne 50--300 atalopram 20~60 2 5-HT NE SNRIs Venlafaxine 75 300 MAOIs 2 NE 5-HT NaSSAs Mirtazapine 15 45 1 2 MAOIs ( ) TCAs Amitriptyline 50~250 Imlpramlne 50~250 Doxeplne 50~250 50~250 Chomipramine Mawotiline 50~225 Mianserin 30~90 Amoxapine 50~500 EPS NE DA NDRIs Buproplon 150 450
75 140 5-HT / SARIs 1razodone 50 300 Nefazodone 50 300 MAOIs Moclobmide 150 600 Tianeptine 25 37.5 MAOIs terfeanadine SSRIs SNRI MAOIs 5.2.4 2-6 SSRIs ++ + + T1/2 (2D6 3A4) ++ ++ + ++ ++ + (2D6) ++ ++ + (1A2) ++ + + SNRIs +++ ++ + NaSSAs ++ ++ + WBC TCAs ++ ++ ++ +++ SARIs + ++ + + ++ +++ + + (3A4)
76 140 NDRIs ++ - ++ + MAOIs + + + + ++ ++ + + ++ +++ SSRIs MAOIs 5.2.5 5.2.5.1 SSRIs NaSSAs SARIs TCAs SNRIs (1 4 mg d) (2 4 mg d) 5.2.5.2 TCAs SSRIs 200 300 mg d 150 250 mg d 150 300 mg d 5.2.5.3 DST.B- MHPG HVA 1 2 5.2.5.4 SSRIs
77 140 SNRIs 5.2.6 5.2.6.1 ICD-l0 / CCMD-3 ( ) (6 ) 10 20?? ( )??????? 5.2.6.2 5.2.6.2.1 TCAs 5.2.6.2.2 750 1 000 mg d 7 14 (T3)25 ug d 1 37 5 50 ug d 1 2 1 2 20 50 (Buspiron) 20 40 mg d 3 (BZD) (1 2 mg d) (5 10 mg d) (0.2 0.6 d) (0.4 0.8 d) 5.2.6.2.3 TCAs SSRIs SSRIs SSRIs TCAs TCAs TCAs TCAs MAOIs MAOIs TCAs 5.2.7 (5.2.6.2) 5.2.8. TEAs 2.5 g 5.2.8.1
78 140 TCAs ( ) 5.2.8.2 TCAs 2 0.5 1 1 2 mg 0 25 g 10 20 mg 6 5.3 5.3.1 (client) 5.3.2 6 12 5.3.3 5.3.3.1
79 140 15-50 5.3.3.2 (psychodynalnic psychotherapy) 1 10 20 40 2 3 5.3.3.3 (cognitive therapy) (CBT) (Here and now) (activity of dysfunction) 5 ( ) ( ) 15 20 40 60 12 15 20 1 3 4 3 4 ( 1 2 1 ) 5.3.3.4
80 140 (behavior therapy) 5.3.3.5 (interpersonal psychotherapy IPT) 3 4 5.3.3.6 (marital therapy) (coupie therapy) (hmily therapy) ( ) 10
81 140 20 ( ) 5.3.4. 2-7 2.7 ( ) ( ) ( ) ( ) 6 12 6 12 5.3.5
82 140 40 60 8 1 23 8 2 1 1 19 1 3 8 20 8 16 2 3 1 5.4 1 2 5.5 5.5.1 (electric convulsive therapy ECT) 60 (electric shock therapy) 70 90 5.5.1.1
83 140 5.5.1.2 5.5.1.3 5.5 1.3.1 8 4 37.5 120 50 150 100 mmhg 90 50 mmhg 15 30 0.5 l.0 mg 15 30 3.0 6.0 mg o 5.5.1.3.2 2 3 (1) (2) 80 120 ma 2 3 10 ma (3) 1 1 1 6 12 o(4) 30 5.5.1.4 4 8 ( ) ( ) 7 10
84 140 5.5.2 20 50 (modifiedeleetric convlsive therapy MECr) MECT MECT MECT ECT 5.5.2.1 ECT MECT ECT MECT 5.5.2.2 0.5 mg 1 1.O mg 2.5 mg kg O.2 ( )0.5 mg 1.5 mg kg ( 2 ) 2 3 30 40. 5.5.2.3 6 ICD-lO
85 140 *1. ECT;2. ECT 7 7.1 7.1.1 ( ) ( ) ( ) 7.1.2 SSRIs 52 SSRIs SNRIs TCAs 7.2 2 1 ( ) 7.2.1 ( ) ( ) 7.2.2 3 TCAs( ) SSRI
86 140 7.2.3 50 75 10 15 3 7.2.3.1 7.2.3.2 2 SSRIs ECT 7.2.4 2.59 7.2.5 7.2.6 7.2.6.1 3 7.2.6.2 ( ) 7.2.6.3 )L ( ) 7.2.6.4
87 140 7.3 0.34 50 70 ( ) 7.3.1 55 7.3.2 7.3.2.1 7.3.2.2 7.3.2.3 SSRIs SNRIs SSRIs SSRIs SSRIs 1 3 l 2 7.3.2.4 7.4 12 36 1 3
88 140 11 26 7.4.1 18 60 16 23 ( 2001) 12 2 33 88 3.5 5 SSRIs SNRIs Na~qAs SSRIs SSRIs 7.4.2 l 3 (Fhval 1982 Kathol 1990) TEAs rcas TCAs SSRIs SNRIs TCAs TCAs 7.4.3 7.4.3.1 62 38 (2002) 312 42 (132 ) ( ) 7.4.3.2 (PSD) 18 79 40 50 10 (2000) 35.4
89 140 SSRIs 7.4.3.3 (PD) 20 60 50 50 ( ) ( ) ECT SSRIs MAOIs 7.4.3.4 18 66 SSRIs 7.4.4 ( ) 7.4.4.1 86 7.4.4.2 9 27 (NIDDM) NIDDM (IDDM) SSRls. ECT ECT ECT EcT ECT ECT 7.4.4.3 (Addison's disease) 30 50 (CRF) (ACTH) ECT 7.4.4.4 76
90 140 l0 TRH 7.4.4.5 42 65 40 7.4.4.6 7.5 25 SSRIs 7.6 3.73 3 48 73 56
91 140 SSRIs C- 8 8.1 1990 140 1.6 (disability.adjusted life years DALY 15.9 1999 WHO 22.2 10 (1993 ) (3 4 ) 20 35 ( 26 67 10 ) 60 140 160 10 60 85.3 10 (11.2 10 ) 8 100 10 (34 66 ) (8 44 ) (3 14 ) ( ) 35 40 5 10. 30 40 5 26 15 15 2 8.2..
92 140 (deliberate self-harm DSH) 8.3 8.3.1 5 (5-HIAA) 5-HT 8.3.2 40 50 20 6 7 ( ) 1 3 30 12 8.3.3 8.3.3.1 8.3.3.2 3. 8.3.3.3. 8.3.3.4 3 8.3.3.5 ( ) 8.3.3.6 8.4 8.4.1 ( )
93 140 8.4.2 8.4.3 ( ) 8.4.4 8.4.5 15 20 8.4.6 8.5 8.5.1 60 1 20
94 140 (45 ) 8.5.2 3 8.5.2.1 8.5.2.2 4.. 8.5.2.3 ( ) 8.5.3 ( ) ( ). Beck (20 ) (12 ) 8.6 ( ) 60 15 2 3 3 6 3
95 140 8.6.1 8.6.1.1 40 8.6.1.2 20 50 ( ) 8.6.1.3 6. 8.6.1.4 4 6 8.6.2 8.6.2.1 8.6.2.2
96 140 ( ) 9 9.1 2002 4 (2002 2010) 2005 40 30 2010 60 50 2005 60 2010 120 9.2 9.2.1 9.2.2 ( ) 9.2.3
97 140 9.2.4 9.2.5 9.3 9.3.1 9.3.2
98 140 9.3.3 9.4 9.4.1 10 30 9.4.2 ( )
99 140 9.4.3 9.4.4 9.4.5 ( 5.3) 9.5 9.5.1
100 140 9.5.2 ( ) ( ) ( ) ( ) ( ) 9.6 9.7 9.7.1 9.7.2 9.7.2.1 ( )? 9.7.2.2 ( ) ( ) 9.7.2.3
101 140 / 4.3 ( ) 5.3 10 (2002 2010 ) 10 10.1 (2002 2010 ) 1 2005 30 2010 50 2 2005 2010 12 3 2005 30 2010 50 4 2005 30 2010 50 5 2005 40 30 2010 60 50 2005 60 2010 120
102 140 6 2005 50 2010 80 2005 50 20lO 80 7 2005 70 1 2010 50 1 10.2 (1) (2) (3) (4) (5) 10.3 (1) ( ) ( ) I (2) (3) 10.4 (1) (2) ( ) 9.3 10.5 10.6 (1) (2) (3) (4)
103 140 11 11.1 11.2 11.3??? 11.4 11.5 11.6
104 140 1980 20 80 5 (SSRIs) 70 10 NDRIs ( ) SARIs ( ) SNRIs ( ) NaSSAs ( ) NaRIs ( ) 11.7 15 l 11.8 11.9. ( )
105 140 1 2 2.1 2.1.1
106 140 2.1.2 2.2 2.3
107 140 3 3.1 3.2 3.2.1 3.2.2 3.2.3 3.2.4
108 140 3.2.5 3.2.6 3.2.7 3.2.8 3.2.9 3.3 3.3.1 3.3.2
109 140 4 4.1 4.1.1
110 140 4.1.2 4.1.3
111 140 4.1.4
112 140 4.2 4.2.1
113 140 4.2.2 4.2.3 4.2.4
114 140 4.3 4.3.1 CCMD-3 WHO ICD-10
115 140 >4 2 4.3.2 DSM- 3-2 DSM- I
116 140 4.4 4.4.1 4.4.2 4.4.3 4.4.4 4.4.5 5 5.1 5.1.1
117 140 5.1.2 5.1.3 5.2 5.2.1
118 140 5.2.2 5.2.3 5.3 5.3.1
119 140 5.3.2 3 3 (mg d) 600 2000 400 1200 500 1200 ( ) ( ) ( ) ( ) 50 500 Stevens-Johnsom ( ) 0.8 1.2mmol L 50 100ug ml 8 12ug ml 25 400 800 2400 50 400 2 5 20 2 2 4 300 700
120 140
121 140 5.3.2.-
122 140
123 140 5.3.3 5.3.4 5.3.5
124 140 5.3.6 5.4 5.5
125 140 6 6.1
126 140 6.2 I 6.2.1 6.2.2
127 140 6.3 6.3.1 6.3.2
128 140 6.4 6.4.1
129 140 6.4.2 7 7.1 7.1.1 7.1.2 7.2 7.2.1
130 140 7.2.2 7.2.3
131 140 7.3 7.3.1 7.3.2
132 140 7.3.3
133 140
134 140 7.4 7.5 7.5.1 7.5.2
135 140 7.5.3 8 8.1 8.2 8.3
136 140 8.4 8.4.1 8.4.2 8.4.3 8 4.4 8.4.5
137 140 8.5 8.6
138 140 9 9.1 (2002 2010 ) 9.2
139 140 9.3 9.4 9.5 9.6 10
140 140