I. Overview: Anxiety-depressive state is a state of persistent worry, anxiety and depression, less pleasant feeling, the patient’s anxiety and depression is often excessive and inappropriate, but can not be controlled, causing some impact on social life and or physical health. The description narrowly includes mixed anxiety-depressive disorder, anxiety disorder with depressed mood, depressive disorder with anxious mood, and somatic disorders with anxious-depressed mood. Because the spectrum of anxiety disorders and depressive disorders is complex, with many overlapping symptoms and co-morbidities, and most patients are first seen in general hospitals, it is difficult to standardize the diagnosis for non-psychiatrists in general hospitals, so in a broad sense the anxiety-depression state includes all anxiety disorders (states) and depressive disorders (states) with or without somatic disorders. This designation is a symptom state description, not a disease diagnosis name. It is mainly seen in the initial impression of the patient by the physician in the general hospital. Second, clinical manifestations: patients have anxiety and or depression, often accompanied by symptoms such as fatigue, inattention and sleep disorders. Patients often visit general hospitals for excessive examination and treatment of autonomic symptoms such as pain, excessive sweating, palpitations, chest tightness and abdominal distension. The following are the specific manifestations of the disease: (1) Worry: Patients are often in a state of distraction and apprehension. (2) Somatic symptoms: pain and fatigue are more prominent, and symptoms can be accumulated in various systems such as respiratory, cardiovascular, digestive, urinary, and neurological, etc. It is common to have panic attacks, chest tightness, shortness of breath, dizziness, dullness, excessive sweating, dry mouth, bitter mouth, foreign body sensation in the throat, stomach discomfort, nausea, abdominal pain, bloating, constipation, frequent urination, neck, shoulder, back and waist pain, muscle tension, numbness, wandering sensation and burning sensation in the trunk, etc. Some patients may develop impotence Some patients may experience impotence, premature ejaculation, menstrual disorders, etc. The above-mentioned somatic symptoms cannot be proved by various clinical examinations with obvious organic diseases, or although organic problems are detected in some patients, their severity is not consistent with the patient’s subjective symptoms. (3) Increased sensitivity: easy to lose temper about trivial matters (knowing that it is unnecessary), good complaints, poor concentration, and often feeling memory loss. Sleep disorders are more prominent, often manifesting as difficulty in falling asleep, excessive dreaming, easy waking, difficulty in falling back to sleep after waking, panic and nervousness after waking, shouting in dreams, etc. (4) Depression: Patients are depressed, unresponsive, significantly and persistently depressed and pessimistic, fretful to do things, and bedridden and lazy all day. Patients with milder degree of depression feel sullen, no sense of joy, lack of interest in everything, sad face, feeling “depressed in the heart”, “can not be happy”; heavy degree of pessimism and despair, there is a sense of life like a year, life is worse than death, patients often complain Patients often complain that “there is no point in living” and “it is hard to feel happy”. (5) Others: Anxiety and depression have a high co-morbidity rate, and such patients are also often combined with alcohol and substance dependence. Other patients have comorbid physical diseases, such as peptic ulcer, hypertension, coronary heart disease, diabetes, rheumatoid arthritis, skin allergy, asthma, etc. Physical diseases and anxiety-depression problems affect each other, complicating the disease, thus delaying recovery and even significantly increasing self-injurious suicide attempts and behaviors. Patients with co-morbidities tend to have more impaired social functioning and respond less well to treatment, making them a high consumer of medical resources. Treatment: (1) Treatment goals: alleviate or eliminate patients’ anxiety and depression and concomitant symptoms, minimize disability and suicide rate; improve patients’ adverse emotions and somatic feelings while treating somatic diseases, stimulate patients’ subjective motivation for treatment; increase restoration of social functions and improve survival quality; prevent relapse. (2) Treatment principles: comprehensive treatment (assessment-based anxiolytic and antidepressant medication, psychosocial family intervention, physical therapy, etc.), long-term standardized treatment (acute phase, consolidation phase, maintenance phase), and individualized treatment. (1) The anxiety-depression state is only an initial impression, not strictly speaking a diagnosis of a specific disease, and psychiatrists should clarify the diagnosis and develop an individualized treatment plan as much as possible in the follow-up consultation. For comprehensive physicians, if the effect is not satisfactory after 2-4 weeks of anti-anxiety and antidepressant treatment, a specialist consultation should be requested early to clarify the diagnosis and standardize treatment. (2) Patients generally take more kinds of medications, do not trust and feel uneasy about the diagnosis and treatment, have poor compliance with treatment, are sensitive to adverse reactions, have severely impaired social life, consume a lot of medical resources and increase the economic burden of the family by repeated visits to the doctor. Therefore, patients and their families need to pay special attention to: take medication on time every day; some drugs may take several weeks to take effect (non-benzodiazepines); continue to take medication after symptoms improve; do not reduce and stop medication on your own; seek timely medical guidance on how to deal with adverse reactions, regular monitoring of liver, kidney and other organ functions and other related problems; make timely and reasonable arrangements for daily activities or sports you like; live, study and work as normally as possible. Work, etc. (3) Prohibit or cautiously use alcohol, weight loss drugs, other psychoactive substances, and reduce smoking while taking medication. (4) If there are co-morbidities that require the combination of multiple drugs, please be sure to use them under medical supervision. (5) Benzodiazepines (Valium) have a faster onset of action than antidepressants (which have anxiolytic effects), and their early application can help patients improve sleep and reduce intolerance in the early stages of antidepressant use. However, long-term use of this class of drugs is not recommended. (6) Anxiety and depressive disorders are associated with psychosocial factors, abnormalities in brain structure and function, genetics, growth environment, repeated negative life events and catastrophic cognition, etc. Therefore, comprehensive treatment is needed, such as assessment-based medication, psychotherapy, physical therapy, family and social interventions, and cultural and physical activities. “Many patients cannot be treated with medication alone.