Fonctions cognitives et réponse à des traitements non pharmacologiques dans la dépression résistante de la personne âgée. Étude de faisabilité et résultats préliminaires

HAL Id: dumas-00746461

https://dumas.ccsd.cnrs.fr/dumas-00746461

Submitted on 29 Oct 2012

HAL is a multi-disciplinary open access archive for the deposit and dissemination of sci-entific research documents, whether they are pub-lished or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers.

L’archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d’enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.

Fonctions cognitives et réponse à des traitements non

pharmacologiques dans la dépression résistante de la

personne âgée. Étude de faisabilité et résultats

préliminaires

Florent Mazzone

To cite this version:

Florent Mazzone. Fonctions cognitives et réponse à des traitements non pharmacologiques dans la dépression résistante de la personne âgée. Étude de faisabilité et résultats préliminaires. Médecine humaine et pathologie. 2012. �dumas-00746461�

123456789AB6C8DC897DC3AEC8C68DC8F2923AC8DC84CE

1223345675444444444444444444444444444444444444444444444444444444444444444444444444444428 6CC8F485C D36268CE89CDC3AEC8 9ABCDEF4 1 1234D 2 4D457!6"!7#$%414&'D'(  ( 44(''4C')DB*'F4D4+4764,)45675

18888 8!8"#88

$"#"%&'8!"8%"8!8"8!8%"88(

')8*87'!8!8+"",%88'%"8%#"8 3-.A32&4A/40/14+44444444444444444444442(('4B(,BDD4331A.2 A.34&3/4A34&53-34+4444444444444444444A4B,6D47B 373-4A/40/14+4444444444444444444444442(('4B(,BDD4331A.2 2(('46BDBCC4451--1323 2(('4ABB4512238/.2 7

4 DB) B444'4%4F(47#;"<4D42,'D 44= 4*'4D(4

CBB(4 FB((4(4D(4B((B(4*'B4D'B4(4C ( (4B>4

=4,(B  (4,FF4CC(4?4D'4''(44*'DD44D'4

4','4CC)B4B4BFC)B!

C9C3AC9CE6 0 4 F,B 4 D 4 A 4 A','@< 4 D 4 A 4 46'>B< 4 A 4 A B< 4 D 4 A 4BBDD< 4 D 4 A4 A'DD< 4 D 4 A 4 A 4 >D 4  4 D 4 2((' 4 3 B 4  4 F>B 4 ,,'BDDB 4 ( 4 D'4 (>B,444F>B4CFB(44)  2B,B44D'4(BCF! 0 4 F,B 4 D 4  4 46((C 4  4 D 4  4 5*'B< 4 D 4 A 4 7B 4  4 F 4 2B4 D6'4=4FF)(4'4D'E44D443 B4>B4,,C 44D4C (B! 04F,B4D4A4A B44F>B4(FB(4D4CF4C'4D4,DBB*'44D4A4 7B4C'4F>B4CCB(4D4BC''4(,BB2B*'! 04F,B4,6D''(F4D4A47B<4'4C<4>B4BBC 4,4>BD4 B(B4*'4C'4(4B(CB)BDB <4((4,(BD(44(4@C B,4*'B4F4  4C ,B'@4 < 4 '4 C< 4  4 F>B 4  4 D>B 4 GCC2B 4 F( 4 ,B((,( 4 (' 4 ,4 >BD44,6,6! 0 4 F,B 4 ' 4 CB,'DBHF 4 A' 4 C' 4  4 ,2B,< 4  4 C (,< 4 4 CB,42,4?4DG>(B <4(4('B(<44BFCBB444(E(HF44B4 C ,B'@! 04F,B4F(4C(<4F4CH4C'4FG>B44>B442B4,4F B<4 C'4(4,B((,(<4(4,(BD(<4(4 'B(4'4434-4446'F'44'4 D42FBDD4 46 B ! 44 FH4C'4 4('B4B,BBD<44 FBB< 4(4 B(C(BB(4,'DBB(444B4C ,B'(4(4D4DCB(B*'! 442H4C'4(4 I4('CB((4J444D4B(B*'4*'B4FG )6B4,6*'4D'4'4C'4CD'(!44FBDD4 C'4B>4?42B4,6)B4%42BDD(44'4KK<4'4446B44C'4D'4('B4 4D'4D'((! 0 4 F,B 4 .C 4  416'B 4 C' 4 D' 4 C ,B'@ 4 ('B(! 4 4D6BD 4 C' 4 4 CB 4  4  4 D>BDB 4 , 4 >( 4  4 F (! 41FB 4 C' 4  4 (C B 4  4 4 ('B! 4 A>B 4 C' 4  4 F' 4  4 DG CEC 4 B*'< 4 ' 4 >BD 4  4 C  DB(!4 3'BDD'F41!4C'4(4CDEDB((44(4(,(F(!44D FB4C'4=4D4('D4?4B4 4F(4FC(!43FBDB43!4C'44D',BB <43FBDB4A!4C'44CB,!45B4C'44 2B DB !4A'4C'44, B>B 4I,  )DJ! 0 4 F,B 4 F( 4 FB( 4 'B(< 4 6>B(< 4 'D'(B(< 4 C'D'C ( 4  L CB(B(44BMB(4C'4'(4,(4)(4FF(4C(( (4(F)D44C'4,'@4?4>B! 7%

58!8","8'%

1213-4+441C,42BD4G1,, BB44>D'B44- 12A34+1C,42BD4C'4D4A >DCCF44D>D'B4 B,D 114+41FB,4(E,6BB,41((,BB 1B44+41,,B4B(,'DB44  )D4 1&A4+41&BA C(('( AA44+4A(LAD4LD44@ 34&4+43D,L4>'D(B>&6 CB 3A4+4CB(4A C((B24D' A14+444A'C41FBB(B 5A-4+45FBD4AC((B4BC4-,D .--4+4.6B)B'4- D,B244D4,C'44D4- B AAA4+4A4AB24AC((B44CDB(<4 C((B4B>442MB( 14+4DB4G1DK6BF 1A-4+4CFE441()C4AC((B4BC4-,D 4+4DB44NB( 14+4(4OC 4 544+4CFF45(CBDB44,6,644DBB*' &-4+44DCDB(4-BF'DB4C B*'4&(,B4 C   &14+4&')D41@B'@ &A4+4&FLA(BL B &A+4&')D4A C((B24D' .4+4.FCB4C4 (,4C B*'

62-5C8DC8926ACC

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

A2)87%38+"'8!8&'88888888888888888888888888888888888888888888841 1L4BDCB(442,'(44B(*'4444444444444444444444444444444444444444444444444444444444444C:5 44444444447L4,'(44B(*'4)BDCB*'44C6DCB(4(FB*'(444444444444444444C:% 44444444445L4&')D(4@B'@44444444444444444444444444444444444444444444444444444444444444444444444444444444C:; 4444444444%L4&')D(4'4(FFBD44444444444444444444444444444444444444444444444444444444444444444444444444C:" 44444444449L4,'(44B(*'4(,B'@444444444444444444444444444444444444444444444444444444444444444444C:" 7L ,'(44C,B444444444444444444444444444444444444444444444444444444444444444444444444444C;6 44444444444444444444444444444444444444444444444 2)8F88$"888888888888888888888888888888888888888888888888888888888888888888888888888888888888888888856 1L )D,B2(444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444C;% 7L  >B444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444C;: 4L &BF4F B,F'@4444444444444444444444444444444444444444444444444444444444444444444C;" F"818*858',%8+8!"8%"8!8!8%"88(88885/ A)88887"%88888888888888888888888888888888888888888888888888888888888888888888888888888888888888888888888885/8 AA)889!+"8''"%8,"%8%8 8%8(8888888888888888888888888888888889: AAA)89!+"88%8 8%8(888888888888888888888888888888888888888888888888888888896 41L44C,B (4,CBB>(4*'B4 ,DB4>,4DPC4444444444444444444444444444444444444444444444C$9 7L B2B,B(4(42,B(4@ ,'B>(44444444444444444444444444444444444444444444444444C$: 5L B2B,B4(4,C,B (4F (B*'(4444444444444444444444444444444444444444444444444444C$; %L B2B,B(4(4,C,B (4BDD(44444444444444444444444444444444444444444444C$" 47L44C,B (4,CBB>(4*'B4(4F DB (4C4D>, 44PC44444444444444444444C$$ 88888A2)81888!8!8%"88(888888888888888888888888889/ 44441L4DB4 F,L C((B444444444444444444444444444444444444444444444444444444444444444444444C$# 44447L4A4 C((B4((,B 4?4D4FDB41DK6BF44444444444444444444444444444444444444C#7 44444L4-EF4 C((B2LE(@ ,'B24444444444444444444444444444444444444444444444444444444444444444C#: 4444AL4&')D(4(42,B(4,CBB>(4(4D4 C((B44D4144444444444444444C#: 4444444444447L4A4C('L F,4 C((B>4444444444444444444444444444444444444444444444444444444444444C#: 4444444445L4,'(44B(*'44  BB4,CBB>4B)')D(4?4D4 C((B44C#: 444444444444%L41B(4(','D(44C6E(BC6DCB4(4')D(4,CBB2(4,( ,'B2(4 '@4 CB((4 C((B2(4444444444444444444444444444444444444444444444444444444444444444444444444C#$ 4444444444449L4.FC,4('4D4,CBB44DG FB4444444444444444444444444444444444444444444444444444444C767

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

F"8=8*858+88)%%8!8!8%8%'8%&'8 !"8%"8!8!8%"88(8>888888888888888888888888888888888888888888888888.=5 A)8F"8!8%?'!8888888888888888888888888888888888888888888888888888888888888888888888888.=5 AA)87'!8!8"8%'888888888888888888888888888888888888888888888888888888888888888888888888888888.4: 88 41L4&B (4C434&4444444444444444444444444444444444444444444444444444444444444444444444444444444444444C7:6 47L4&B (4C4&-44444444444444444444444444444444444444444444444444444444444444444444444444444444444C7"9 AAA)8D'8888888888888888888888888888888888888888888888888888888888888888888888888888888888888888888.91 F"848*83%'888888888888888888888888888888888888888888888888888888888888888888888888888888888./=8

8888888888888888888888

8

1234256789A2BCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC9DEF BBCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC9DF

A!' 1'D'6'B<44,<4746)B4('4;4(4PC 44;:4(44CD'(49CD'(447:4R44D 4 CC'DB 4 D 4  4 D( 4 C(( 4  4 $: 4 ( 4  4 CD'( 4 ( 4 5 4 FBDDB( 4 99 4 R 4  4 D4 CC'DB4D497! A4>BBDDB((F4CD)D44D4CC'DB4(4C))DF4D'4(4C6 FH(4*'B4 ,, B(442M4F*'4D4SS.4(BH,D!4 ,4?4,4@CD(B4 FCC6B*'4(4C((4PC (<4D4FBH44,(B 4 D4>BBDDB((F44D(4C)DHF(44( 4*'B4D'B4(4,6 (<44)','C4 >D' ! A4,44DCFC(4  44,(B 4D4( 4(4('D(4PC (4'B*'F44 F(4(C ,44>B!4AC'B(4D4S.S4(BH,D<4D(C ,44>B44'CF 44 2M 4 (C,,'DB< 4 , 4 *'B 4 ( 4 ,(B  4 ,FF 4 D' 4 ( 4 C( 4 CCH( 4 DB 4 ? 4 D4 F ,B44'@4,BB(44>B!4A(4B*'B '(4,,4D4*'DB 4(4 (4 4>B4B(B4CC (44('(,B 44F)'@4>'@44,6,6!4.D(44F 4*'4 D(C ,44>B4((4B>DBB 4C6E(B*'4<4DD4'((B<4)','C4'CF <4,4*'B4 BDD'( 4 D 4  '((B 4  4 , 4 >D'B 4 *'B 4 ,,' 4 ? 4  4 D 4 CD'( 4 C((B)D 4 D4  C,4C6E(B*'! ' 4 D 4  C, 4 C6E(B*'< 4 BD 4 CCT 4  4 CD'( 4  4 CD'( 4 ,DBF 4 *' 4 D4  C,4C(E,6B*'4C (4'4BF(B4FD'44D4( 4(4C((4 PC (!444 C,4B>B4C'4'4DC4C4(4D'FB4CD)D44D4 B(*'4 44B(B'B4+4422<4,6K4D(4C((4PC (42CBD(<4DD4>B4 D42,'4CB,BCD<4DBFB4D4FBB4?4FB,BD! A(4')D(4,CBB2(4B>B4C'4'4DC4C4(4,4 C,<4U4D4 C4B =4*'B4D'4(4C 4,'DDF! B(< 4 'LD? 4  4 ,(4 ')D(< 4 D( 4 (EFCEF( 4C(E,6BB*'( 4CH(< 4 '@ 4 '((B< 4 '4 CB(4@=FF4BFC44,(B'4 CDF4'42,'4FD'4,'B(4 D(4('D(4PC (4?444B(B'B4B(B4*''4FB242 *'44F44(B(4 4B>B(4(C ,BDB( (!

A4 C((B4(4D4C6DCB4C(E,6BB*'4D4CD'(42 *'FF4, !4A(4D4 F<4CD'(447664FBDDB(44('D(4'B4(4')D(4 C((B2(!446K4D4('D4 PC 49V4;:4(<4D4C >D,44D4 C((B44CC'DB4C  D4(4(BF 44

744:R495<4'@*'D(4BD42'4D'4764?47:4R44')D(4E(6EFB*'(9%!43DD4(4 C'4DCF4('(LBC(B*' 44('(LB <4,FF4D4,2BF4D(F)D4 (4 '(499<:! ACH( 4 DGCB(B 4 FBD 4  4 D 4 - 4 9- 49;< 4 B,B 4 5656< 4 D 4  C((B4 >B 4 D 4 5,'( 4 B>DBB 4 ? 4 >( 4 D 4 F< 4 CH( 4 D( 4 ')D(4 ,B>(,'DB( 49;4  4 C ( 4 D 4 '@BHF 4 ,'( 4 = 4 FDB 4 ' 4 B>'4 'C ! A 4 L,B((, 4 ( 4 ( 4  C((B2( 4  4 C' 4 ,( *', 4 DG'CFB 4 '4 '@44('B,B4(''4CH(4$64(!4A4B(*'44C((C4?4DG,4('B,BB4(4)B4 CD'(4BFC4*'4,6K4D'D4D'! A4 CD'(< 4 FDC 4 D(4 >, ( 4  4 C(E,6C6F,DCB< 4 D 4  (B(, 4 6 C'B*'4 (4'4C)DHF4FD'44( 4C')DB*'!4A4 FB((B4B,FCDH4(42 *'44 D >D'B4('>4,6B*'!4 -B4D4CD'C4(4 CB((4 C((B2(4 C((4D(4 '4CFB4BF<4BD4(4FB(4*'4:64?4":4R4(4CB(4'4'4FB(4'4  ,', 4  C((B> 49"! 4 .D 4 ( 4 (BF 4 *' 4 56 4 R 4  4 ,( 4 CB(( 4  C((B2( 4 (4 ,6B,B(44*'4%64R4(4 C((B(4 (B(4'@4F B,F(4B C(('(4 9$ 4!4A(4 C((B(4'4('D4PC 4(4?46'4B(*'44,6'444 ,',<4D 4 CD'(4('>4(4D(4'@4CFBH(4 (4CH(4D CB(! A D,,>'D(B>6 CB 4 934& 4 ( 4 CH( 4 "6 4  ( 4 'BDB(B< 4 D 4 ICDL (J44FBH44BF4(4 C((B(<4( >H(44 (B((4FB(4DD44 C'4 C4?4DD4('D4'@4B('22B(,(4(4C(E,6C(44(4C(E,66 CB(! 4(4C'*'B4(4,6FC(44D4,6,64(4(4B (( (4?44'>DD(46 CB(<4 ,FF4D4(BF'DB4FC B*'4(,PB49&-44CDB(4*'B4C(4('4D4 CB,BC 4  4 DB',B 4 D,FC B*'! 4 4( 4 ' 4 F 6 4  4 (BF'DB 4 4 B>(B>< 4  >DCC  4 ' 4 FBDB' 4 ( 4  ( 4 $6< 4 *'B 4  4 *'B 4 ',' 4 (6 (B4 C  D44C'4=4FBB( 4(4'4,4F)'DB! 2 4 >BD 4 C( 4 (' 4 ' 4 ' 4 C(C,B> 4 (' 4 ' 4 CB 4 F) 4  4 ,( 4 C'4  F4D4CB,4446EC6H(!42'(4C((4*'4D(4')D(4,CBB2(4 ( 4 ' 4 2,' 4 DBFB 4 DG22B,,B 4  4 D 4  C( 4 6 C'B*'< 4  4 CD'(4 CB,'DBHF 4 D( 4 2,B( 4 @ ,'B>(! 4 2'( 4 ,6,6( 4 ? 4 BB2B 4 D( 4 2,'(4 ,CBB2( 4 *'B 4 ( 4 (C()D( 4 G' 4  (B(, 4 ( 4 D 4 BF 4 4 C6F,DCB*'44D4 C((B4 (B(44D4C(4PC !4

F"8.*858,%0#8!'8"#8!"8%"8!8!8%"8

8(

A)8A!'8

3 4 B( 4  4 (( 4 ,( *',(< 4 D 4  C((B 4  4 D 4 C( 4 PC  4 91 4 ( 4 '4 BFC4C)DHF44( 4C')DB*'!43DD4(4((,B 4?4'4'CFB4'4B(*'4 4F)BB <4'4'CFB4'4B(*'44('B,B<4'4BFB'B44D 44( 4 CD)D< 4 C6E(B*'< 4 ,CBB2 4  4 (,BD< 4 ' 4 CD'( 4 C 4  CDBC, 4  4 ( 4 CC4 C(<44*'B4,4(4'(4((,B (4?4'4'CFB44D4FDB !49%! B(4,BF4?4,4*'4'(4C(B(<4D CB(4 C((B24FD'4(B4FB(4 2 *'4,6K4D414*'4,6K4D'D4CD'(4D'954! A 4  C((B 4 ' 4 ('D 4 PC 4 B22H 4  4 ,DD 4 ' 4 CD'( 4 D' 4 'D! 4 A 4 C (B4 ( FBDCB*'4BC(B*'<4D(4 BDCB(<4D(42,'(44B(*'44C,'(4(4 '(4(4(C,(4*'B42DH4D(4,, B(B*'(4CB,'DBH(44D4 C((B44,6K4D4 1! A 4 ,B((, 4 4 D 4 2M 4 4 DGPC4 C' 4 FB2B4 ,( 4 2,'( 4 ((,B ( 4 ?4 DGCCBB44'4FBB44D4 C((B4(4((BDD4C'4'4BF422B,,4 4D4 C((B4(41! AGPC4GCCBB4'4')D4 C((B24(4((BD<4BD4CF44B(BC'4,'@4*'B4 (4(B'44D(4C((4*'B44 D?4('224G'4FDB4FD4CD'(4E4(4 D4>B44,'@44D4CFBH4,4>,4D4FDB4FD4('>B4?4'4PC4 >, !4A4B(B,B4(4B22 ,(4(4DG BDCB44D4C(B,<4FB(4'((B4(4 B22 ,(4(4DG@C B,4> ,'4G>B4'4C6DCB4FD! 57

AA8@8C!#%8*

2)87"%8*

A(4 ('D(4(4 '(4 CB FBDCB*'(4('4D4 C((B4>B442,B4(4  2BBB(44D4 C((B44(4F 6(4BB2B,B44 >D'B!4.D4(F)D4 *' 4 D 4 C)DHF 4 CB,BCD 4  (B 4 ( 4 D 4 ,6B@ 4 ( 4 ,BH( 4 BC(B*'( 4  4 (4 C'F( 4 *' 4 D 4  C((B 4  4 D 4 14 C' 4 C ( 4 ( 4 C2BD( 4 (EFCFB*'(4 B22 (44,'@4)(> (4,6K4D(4'D(4D'(!4.D4(CB4'42F4,DBB*'4U4 D(4B22 ,(4(EFCFB*'(4C'>4C (4(4('(LEC(44')D(4DB (4'4 >BBDDB((F4'4,>'!  4 (B< 4 C 4 BDD'(< 4 *' 4 D  4  4 ( 4 ( 4 C(( 4 PC ( 4 (( 4 CD)DF4 F DB 4 ' 4 ,'( 4  4 ,( 4 BH( 4  (! 4 .D 4 2' 4 '2B( 4 ('DBC 4 *' 4 ,4 )(>B4,'>4(4(B'B(42F46  CH(!43422<4D 44( 4 ' 4 C( 4 B(B'BDB(  4  4 B 4  4 ,FF' 4 >, 4 ,D'B 4 ' 4 C(4 'F4>B>4?4(4FB,BD!44'>4 CDF4,46  C  B 4D(*'4 (B ((4?4D4C >D,44D4 C((B!44(4B(B4*'4D(4''(4(,,4 C'4 ,B4,4C >D,442,B44D4(B'B4(4('D(!4.D4@B(4(4 '(4  4 CC'DB 4 C  D< 4 ( 4 '( 4  4 (',' 4  4 (B( 4  4 6 )CF 4  4 D(4  ('D(4(42(4B22 (! 3 4 CC'DB 4 C  D< 4 D 4 '@ 4  4 C >D, 4 ( 4 (BF 4  4 7 4  4 :R 4 C' 4 '4 CB(4 C((B24FD'4 2BB4(D4D4A-.B4CH(4;:4(495! 44*'B4 *'B>'4?4'4B,B,446447:4R4C449#! A4C >D,497644DB,B,4497744DG3A4')D4CH(4DPC44"6L$:4(! -,6 4 *'G 4 '>4 476 4 ? 4 7: 4 R 4  4 ')D( 4 E(6EFB*'( 4 9% 4 CFB 4 ,4 CC'DB4*'4'(4DD(4 2BB4CD'(4DB! A(4 '(4 DB( (44F ,B4C  D4F4*'>B4:4?4764R4(414*'B4 ,('D44 F ,B4C  D< 4C (4(4 (EFCEF(4 C((B2(4 (BCB2B,B2(4 975!44(4('>4'4')D4(FB*'4*'B4C'((4D4('D4?4,('D<4,4*'B44D4 BC(B,4CD'(4B22B,BD! 46K 4 D( 4 CB( 4 6(CBDB( ( 4 ( 4 D( 4 B22 ( 4 (>B,( 4 6(CBDB(< 4  4 '>4 476447:4R!

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

-)83%"+"88!"8!8',%8!+88"

A)(,D 4 CB,BCD 4 ' 4 BC(B, 4  4 D 4  C((B 4 ,6K 4 D( 4 ('D( 4 PC ( 4 ( 4 C(4 ('DF4D(4CB,'DB (4( FBDCB*'44D4C6DCB4 C((B><4FB(4 CDF4 DB'4(4F ,B(42,4'4>BBDDB((F4*'B44,4?4((BFBD4B(((4?4 >BBDD((<4(''4CH(4$64(! 4444444 A(4CB,'DB (4,DBB*'(44D4 C((B4,6K4D41<*'4'(4DD(4 BDD 4CD'(4 DB4(4,, B(4CB,BCDF4C4+ L4'4@C((B4FB44D4B((( L 4 ( 4 CDB( 4 (FB*'( 4 2 *'( 4 92F 4  4  C((B 4 F(*'  4 B(B 4 '4 (EF4'D''@4B4(E( FB*'F42B4 >*'4'4 C((B4,6K4D41 L 4 ' 4 CDB 4 (')D,B> 4  4 F FB< 4 >B 4 ( 4 ')D( 4 ,CBB2( 4 >  (< 4 , 4 '4  C((B 4 >, 4  2B,B 4 ,CBB2 4 ' 4 ' 4 2F 4  4  C((B 4  DB 4 B 4 2B4 ,6,64'4C((B)D4(EF4 FBD C8'#38%?!#%8!8%"8!8!8%"8F2 1Prévalence 2 C8'%"8"%388.8848B8"8CD98C548" 2 C8#!8"%848 8.:B8!8F2 2 3$A8%8"8$"%88.:88.48B 2 3$A8%8'D8'"%38'8"!8%8=:8B 1Prévalence entre 4 et 13 % dans le trouble dépressif mineur 1A!88:88.48B8"8"E 1F"%88!8!8%?CD98!',%8"08%8(8!8F:)948" 1DG$G#8D'&'8 8.:8 8.48B 1F"%8!'8'!8!"8%"8!8!8%"8F28#,%8H8&'"8+8 %'8%8&'8$A8%8D'38!"84=8 8F/8B8!8" 4

L4'4@B  4Q'4')D(4'4,,H4CD'(4F*' (49 C((B46(BD<4 C((B4 @B'( L4'4C6B4((,B  L' 4  C((B 4 F D,DB*' 4 *'B 4 ( 4 ' 4 'C, 4 6 C'B*' 4 9B((F4 (FB*'4CB<4B(*'4('B,BB4 D> <4(EF44CDB((F L 4'4  C((B 4?4 )'4 B2< 4 ('> 4,6K4' 4CB4 4 ;64 (4  4CD'(< 4((4  , 4 C((B2<4D4CD'(42 *'4,6K4D41! D'(B'(4')D(4 C((B2(4(4 ,B(4(4D4'D4BC(B*'44(B(B*'4 (4')D(4F'@4994 BB<4D4A-L.BL&<41FB,4(E,6BB,41((,BB<4 5666 4 979 4  4 D 4 4.L76 4 94D((B2B,B 4 BBD 4 ( 4 FDB(< 4 C')DB  4 C4 DCB(B4BD44D4( 447##;44D4')D4 C((B24FD'<4')D4 E(6EFB*'< 4 D 4 ')D 4 )BCDB 4  4 D( 4 ')D( 4  4 DG6'F' 4'( 4 ? 4 ' 4 22,B4 F B,D4 C  D! 4 A 4 ')D4 GCB 4 >,4 6'F' 4  C((B> 4C'4 '((B4 =4 ,(B  4,FF4'42F44 C((B! A4 BC(B,44')D4 C((B2 4FD' 4  ,((B4 D4C (,4(B4'4 6'F'4  C((B>49B(4(B4'4C4B =4'44CDB(B4C'4'4' 4'4FB(4 '@ 4 (FB(9,2 44D((B2B,B 4  4 BC(B, 4 ( 4 ')D( 4  C((B2( 4  4 C BB<4 1@47!444 =F 4 (GBD 4 ( 4 D 4  2 , 4 BBD 4  4 5675< 4 D( 4 ,BH( 4 BC(B*'( 4 '4 A-L.BL&4(4B22B,BDF4CCDB,)D4?4D41!4 1B(B444C'4BC4*'4D4B(B,B44 C((B4F  44( >H4G(4 C(4) ! AGBDD'(47BL3'BDD'F44566$497:4 >*'4D42B4*'4D4F'D4'4A-L.BL &4G(4C(4C 4'@4 C((B(44D41!4A(4D4CC'DB4C  D4PC <4('D(4 7$4?456R4(4('D(4 C4'@4,BH(4G3A<4D(4*'4:6R4C (4'4 (EFCFDCB4 C((B>4IB2,DBB*'J44(4 C'DBHF4@,D'(4(4>'@4 4,6,6497;! 5:

G$08;.F<8'8%8"8%&'8!8%"8!8!'8'D8(8 !'8* )8G#I#8!!"8!8%8( 3 A ((CB<4C((BFB(F<4C44DB,BCB 3 &')D(44D6'F'<4@B  3  ((BF44(B 3 16 B 3 1@B<4FBCB((F<4')D(4'4(FFBD 3 DB((F4C(E,6F' )8G#I#8%'8'88$A8%8'D8D' 3 4'DC)BDB 3 3@C((B44D4'D'4FD 3 7B((44D22B,,B 4(4D(4,(44D4>B4(,BD 3 4C2((BDD 3 7B((44D4DB)B 3 . B4('B,BB )G#I#8+&'8 8%"88( 3 .()BDB <4C((B>B <4,DH 3 -FB(B(<46EC,B 3 A FB>B<4'B<4((B4'D''(44>B4B B' 3 CDB4('4(B<4B(DF 3 1CB((4FBD 3 42'(B 3 A C, 3 &')D(4F (B*'(4DD C' ( 3 .FC((B4B'BDB <4('B,B(4CCFF (44 '((B(

1

6',%8!G$G#&'

4444444 A4')D4E(6EFB*'44*'B4(4'4')D4 C((B24B(B 4D CH4'4F  4*'B4 '4'4FB(4'@4(49,24@47<4(4CD'(42 *'FF4, 4,6K4D4CB4 PC 4 C4?4,B(4,BH(4+4'4PC4>, <44(@4F(,'DB<4)CB*'<44)(4 B>' 4 ',B<4,(FF4CD'(44'@4F B,F(44E4'4B>'44 2,BF 4 BFB' ! 4 A 4 C4 FDB 4 ( 4 ('D( 4 E(6EFB*'(4C (4 (4 (EFCEF(4@BL C((B2(44(4,4>'(44CBB 4C4D4F ,B4C  DB(44 4C4D4C(E,6B!432B<4BD42'4('DBC4DBFC,4'4C((C4?4D4,6B,B 4 ( 4 , 4 CC'DB! 4A 4 E(6EFB 4 ,(B' 4 ' 4 2,' 4  4 B(*' 4 BFC 44  C((B4FD'44(42 *'FF4((,B 4'@4C6DCB(4CB*'4,6B*'4 97$!

1

6',%8!+8#'

A4')D4 C((B24FB'4(4D4CD'(4('>4((,B 4?4'4B,C,B 42,BDD!4 3>B45:R4(4CB(4 >DCC4'4')D4 C((B24FD'4(4D(4'@4 (497#<56! 46K4D(4CB(4D(4CD'(4>B'@<4'4DC'4C6(4(')L(EFB*'444B(4(4C'4 C ,  4 D 4 ')D 4  C((B2 4 FD' 4 9#!4 4 ')D 4 F B 4 , 4 ' 4 B4 CB,'DBH44DG(F)D4(4(BC(!

1

6',%8,%"

A4')D4)BCDB4.4(4BC(B*' 4,6K4D(4CB(4('2244 C((B4 FD'4*'B44'46B(B4G'4FB(4'4 CB(4FB*'4'4FB@<44D4')D4 )BCDB4..4(4BC(B*' 4,6K4,'@4*'B44(4 CB((44 C((B4FD'44 (4 , (4G CB((46ECFB*'(!4A(4CB(4PC (4B(44D4FDB4 )BCDB44(4 CB((4C>(44B>DB4957!4A'4'@44FDB 4(4CD'(4 D> 4*'4,6K4D(4CB(4B(44')D4 C((B24FD'4955<4,4(44CD'(4 C4,(FF'44(B(44( 4FD44(4'(4(>B,(44(B(4 F B,'@495%<59! 5"

1

6',%8!+8"8G#I#8G$&'

A4 C((B4>,4(EFCEF(4C(E,6B*'44C'C4(4B (4 DB4'4(4 6DD',BB(!4A(46 FB*'(4 DB(4(4 (4 C((B2(4(4CD'E4D4 ,'DC)BDB <4D6EC,6B<4D(4B (44'B<4D4C( ,'B44C2B(4D4DD'(B49#!

3)83#,!8"8

.8)8DJ8 8'8"++8#!"%8"%8

A(4(EF(4 C((B2(44D414('>B4('>4(4D4,@44(B(4 F B,'@444')D(4'DCB*'(495:! 4'>4'4 4 C((B24F4?4'422,B4F B,D4C  D4D(4+ L4'4B2,B4>BD L4'4,BC6B<46EC6EWB<46EC6EWB<46ECLC6EWB<46ECL C6EWB<4B('22B(,4(' DB<46EC,B,B(F<4FDB444'(6BC! L4'4,,4F (( <4'4D', FB<4'4,,4'4C, (<44DEFC6F! L4'4FDB4,  )L>(,'DB4+4B2,'(4D,'B<4,,B4>(,'DB4,  )D<4  F,4>(,'DB! L4'4B2,'(4'4FE,! L4'44')D4F )DB*'4+4,,44>BFB4775<4DB 4?4D4FD'BB! D'(4 D(4,F)BB (4(4 BFC(4 4D'(<4CD'(4D4B(*'44 C((B4 (4 C495:<5;! 4B(4C('D4*'4D 44(((<44 C((B4FD'<444FDB4F B,D4 (4 ,BC*'F4DB (4'4(((4*'B42>B(4DGCB49DD((B<4FB(4*'4D(4 F B'(44D4 C(4'4(((44(4C(4B6B) (49 4DD(B*'4DGBFF'B 4(4 D  <4DG B(,D (4(42>B( <4,FF4DG) (B <4D4 FB DB(B4(('(<44 DGC6B4(4,DD'D(4'4,>'4'CF4C4BDD'(495"!4A 4DD(B*'<4*'B4 (@CBF 4 ,FF 4 ' 4 'CFB 4  4 D,B>B 4 ,B,(' D< 4 T 4 '4 'CFB4(4,,B(4'42,'44,B((,44DB('DB49.34L7<44 DGBBBB 4 4 D4  C(4 B2DFFB< 4 (4 '> 4 ,6K 4 D( 4CB(4 ('224 4  C((B4FD'495"!

18)8DJ8 8'88#!"#'

ACH(41D@C'D(44566:9#<4D4 C((B4,6K4D4C(4PC 4B'B4C4(4 F B,F(<4(4 2BB4C4(4CB(4*'B4 >DCC4'46'F'4B(4'4'4 6 B4(4'(4'4C(*'4'(4D(4,B>B (4C'B(4'4FB(4GB@B,B4?4 '4(')(,<4'4'4B<4'4?4D'BDB(B44F B,F(4B,F4DB (4?4D4  C((B4+ L4 6EDC L4)KBK CB(4 L4CDD4 L4 (CB L4( W(4 L4F B,F(4BLCNB(B(4 L4X4)D*'( L4,BF BB L44,DBB4 L445EDKB4 L4(CH(<4CC( 4 L4F@B2H4 L4>B)D(B<4>B,B(B4 L4A@CC@EC6H A6EC(B4B(DB*'4(4((,B 4?4'422,4C(BB242B)D<4,4*'B4C'4@CDB*'4 C'*'B4D4 C((B4C'4=4'4224(,B44,B(4F B,F(4BL 6EC('(4D(4*'4D(4)=L)D*'(49%! .D442'4C(4')DB4*'4,(4F B,F(424CB(4(4FE(4?4D4B(C(BB4 (414C'422,'4'4C((C4?4DG,4('B,BB!

D8)88'!8$A8%"88(

A4 ('D4CBDDF4CB*'44D4 C((B44D414(4)B4D4('B,B! A(4'@44('B,B4(4D4CD'C4(4CE(44(4,'D'(4(4%4?4942B(4CD'(4 D> 4 ,6K4D(46FF(4*'4,6K4D(42FF(4?4'(4D(4PC(<4FB(4DG ,4'CF442B44 >B4'4?4'4'CFB4(C,,'DB4'4B(*'4C'4D(46FF(44'4D CH4 BFB'B4C'4D(42FF(4C4CC4?4D4*'B495$ ACH(4D '44BB4('4D4CC'DB4F B,B44D45666495#<4D4('B,B4 (4C(*'4'@42B(4CD'(42 *'4,6K4D(414*'4(4D4CC'DB4C  D! Parmi ceux qui font une tentative de suicide, les PA sont plus susceptibles de mourir (30).

A4,FCF4('B,BB442B44>B4B22H4?4CD'(B'(4 C(44,D'B4)(> 4 CD'(4E4(4D4>B!4A(4144,4?4'BDB(4(4FE(4CD'(4I4B,'@J<44D4 ,FCF4('B,BB4(4CD'(4('(,CB)D4G=4FD4,6K4D(414*'G?4'4'4 PC!434'<4D(4 ,H(4C4('B,B4(4142DH4'4B>'4CD'(4 D> 4GBB4 4'4CDB2B,B4CD'(4BFC4*'4D'(46FDC'(4CD'(4D'(49%7!4A(414 (4 FB( 4 ('(,CB)D( 4  4 >)DB( 4 D(4C( ( 4 ('B,BB( 4 ,FCB>F 4 '@4 'D(4CD'(4D'(!434>,6<4D(4144'4'@4CD'(4 D> 4GB (4('B,BB<4 ,FF4(BD4(CB((B4'4('6B44F4IC((B>J!4AB B4('B,BB4(4DB 4?4 D4( > B 44D4 C((B! / 4 BH 4 B22 , 4 BFC 4  4 D( 4 1 4 *'B 4 ( 4 ('B,BB( 4  4 D'(4 6FDC'( 4 CD'( 4 D'(< 4 ,G( 4 *' 4 D( 4 'D( 4 CD'( 4 PC ( 4 ( 4 CB,'DBHF4 ('(,CB)D(44,('D4'4F ,B4C'4>4D4F49%5!4FB4D(4'D(4*'B4 (4F(4'4('B,B4?4DGPC44::4(4'4CD'(<4D'(*'G?4"6R44>B(B 4'4F ,B 4 C  DB(4'@43(L'B(4(4D4FB(4'4 ,H(4CH(4D '44A'F4456654 9%5! /4(EF4 C((B24(4C (4,6K4$6R4(4144CD'(44"94(4*'B4(4('B,B4 9%%!4A CB(4 C((B24FD'4(4'42,'44B(*'44('B,B444B>44 ('B,B 4 F B,F'(! 4 A 4 ')D 4  C((B24 FB'< 4 D 4 ')D 4 E(6EFB*'< 4 D(4 ')D(4C(E,6B*'(44D(4')D(4@B'@4C'>4 CDF4'CF4D4B(*'4  4 ('B,B! 4A( 4 ,F)BB ( 4 (FB*'( 4 B(B 4 *' 4 D 4 C 4 B,C,B 4 (4 CDF4(42,'(44B(*'44('B,B4FB(4*'B4'@4(4 C44DB(B 4 4D4 C((B49%6!44BDD'(<44C'4C ,B(4*'4D4'C'4(4DB(4(,B'@<4 DB(DF4,6K4D(414('B,BB<4(4B C(44D4 C((B<4(''4,6K4D( 4 14E4(4B(44C(DB 4@B'(4Q'4)(((BDD49%9! AG)'(4GD,D4'CF4D4B(*'44('B,B4,6K4D(41! A4B(CB)BDB 4(4F(4?42'4')D4D4B(*'44('B,B4,6K4D41!49%:! A ' 4 1D@C'D( 4  4 7### 4 9%; 4 (' 4 D( 4  FB( 4 ( 4 B ( 4  4 (4 ,FCF( 4('B,BB( 44 F 4D( 4G'4 >D'B 4BBBD4( 414('224 '4 4 C((B24FD'<4D4( > B 44D4 C((B44D4C>B 4(4B>(44 ('B,B4C , (4C'B4C B4D >D'B4IC DB>J4(4B (4('B,BB(4! 1B(B4D4CD'C4(4CC,6(44C >B44C'4)D,B24DGBB2B,B44D4 BF44D4 C((B44DD(44 F 4D'422B,,B !

2'( 4 DD( 4 ? 4 C ( 4  >DCC 4 D( 4 (C ,B2B,B ( 4BC(B*' 4  4 ,DBB*' 4  4 D4  C((B44D4C(4PC !

AAA)8+8!"&'88%&'8!8%"8!8!8%"8

8(

2)8)86',%8!+8#"&'

46K4D41<4D4 C((B4(4H(4('>4F(*' 49%"!4A(4(EFCEF(4(4D(4 CD'E 4 C6E(B*' 4 *' 4 C(E,6DCB*'(! 4 ABH 4 ,( 4 F(*'(< 4 BD 4 2' 4 ,6,6 4 '4 'D' 4 FD 4  4 D( 4 (EFCEF( 4  C((B2( 4 *' 4 '( 4 >( 4  D? 4 >*' (4 C , FF! 3 4CD'(4 ( 42F(4 ,B>4 4  FBD4 *'4'(4 BDD(4CD'(4DB<4 4C'4 '>< 4 F=F 4 (B 4 ,B( 4 ''( 4  4 (G,, 4 C( 4 D?L(('(< 4 ( 4 ')D(4  C((B2( 4 ? 4 F(*' 4 (FB*'< 4 6EC,B*'< 4  DB< 4 6(BD< 4 @B'@ 4 4 ,2'(BD! %7 C8'# 3 '!88&'8!'K8+8%'8+&'8$A8%8F28&'8!"8%"8 '%"8"% 3 9G8%'8L"!"'KM 3 E"'8!?"%88!8%"+"8%'8%8 3 2,"%8# 3 6"'K8%'8%8!?!8'!" 3 A!"8'!"8%8 8%"88!8%"8!E 3 F28'%8%'8'8%'8978""8""8 8%?"8'

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

< 4 '4 C6DCB4  DB 4 B>4 4 4 C(,B 4 ( 4 'DCB*'(!4 A(4 B (4  DB( 4D(4CD'(4 2 *'( 4(4D(4 B (4B,')BDB < 4 *'B4 (4C (4CD'E4 ,FF4'4C4(CB<4'4D(4B (44'B!4-'><4D4> ,'4 DB4C'4=4 C( ,'B2 4  4,C' 4 ? 4 D6'F' 4 , 4 BD 4  4 ' 4 DB 4 B(! 4 4C< 4 BD 4 2'4 ('DBC 4*'4,(4,, B(B*'(4C'>4=4)((44*'4D(4B (4 DB(4 C'>4=4H(4>B (!4APC4,(B'<4422<4'42,'44B(*'4'4 DB!4A4  C((B4(<4>,4D(4(EF(4 FBD(<4D4CFBH4 BDCB4'4 DB4,6K4D4 ('D4PC 4999!4.D42'4,4(E( FB*'F4E4C(4>4'4)D'4 DB444 ,6,64D(4(BC(4(C ,B2B*'(! =8)9"&'8$% A(4 C((B(46(BD(4(4,, B(B*'(4' 4('D4PC 499:43DD(4(4FB2(4 C44DC((B>B 44'4@B  4,,FCC 4'4CBB46(BD!4A(4CB(4 (4C2B(4,DC' (4,FF4I,, BD(J!4A(4,6CF(4BFC(44 ,(4 '4,FCF4B>42B4 >*'4D4 C((B! 48)9"&'8"K'K A 4  C((B 4 @B'( 4 > 4  4 DCCFB(F< 4 F 4 ? 4DB6B)BB 4  4 D,B< 4 ?4 DCBB4@B'(44)'BDD<4>B4?4D4,2'(B!4A4CB4>)DB(4 C  D4(4@B  4*'B4(4'4CFB4CD44D4C6DCB!4442F4FB@4@BL  C((B>4(4D4CD'(42 *'4,6K4D42FF4PC 44C'4,'B4('>4?4'4 C(,BCB4B(D 4G@BDEB*'(499;!444@B  4C'4C2B(4C  4'4 CB(4 ,2'(BD! 58)9"&'8+'%8 4 44F(*'4(4F*' 4C4,4@B  <4*'B4C'4B4'4B(B 4(B4 D> 4*'GBD4 C'4C  4(4(EFCEF(4GDD'4,2'(BDD497"!4A4CB4(4D(4  (B <44(4CC(4CD'(4'4FB(4,6 (!4.D4GE44C(4,C44 DD4 )')BDB44D4,(,B,<4FB(4CD'E44C>(4')D(44DGB4>,4(4 BC B(4 (44D4 DB ! %%

-)6',%8!+8"!+

A(4 C((B(4?4 )'4B2<4 2BB(4C4'4 )'4CH(4;:1(4'4CH(4;61(4 ('B> 4 D( 4 ''(< 4 (4 ( 4  C((B( 4 ('> 4 ,6K4 ' 4 CB 4 D'(*' 4 D? 4 ((4  , ! 4 4( 4  C((B( 4 C ( 4 D4 (B'B 4 ,DBB*' 4 D 4CD'( 4 2 *'FF4 , 4,6K4D(4('D(4PC (!4A'4B(DF44'4B =4('4D4CD4,DBB*'44('4 D4CD46 C'B*'! -'4D4CD4,DBB*'<4)','C4''(4('DBC4D4B(*'4 >D'B24(4 C((B(4 B( 4 B>( 4 >( 4 ' 4 (EF 4  FBD 4  4 D' 4 2 4 ((,BB 4 ? 4 ( 4 2,'(4 >(,'DB(499"<9$!41'LD?44,4CB44>'4,DBB*'<4'(4''(4 >DCC4 '4CC,64BF(BDD44,(4 C((B(4((,B (4?4(4B(4'4(E(HF4 >'@4,D!4A(4 C((B(4B>(4(4,, B( (4C4'42 *',4 D> 4 FDB( 4 ? 4 D@F 4 'C(E,6DCB*' 4  4  4 BFCB 4 ,  )D< 4 '4  C,4,,'<4'4F)BB 4C6E(B*'4CD'(4C44'4FDB 4'CF !4 A'4 C(4'4BF4(B4FB(4)<4D'4 >D'B4F*' 4C4'4CD'(4 C4,6B,B 4>,4'4B(*'4CD'(4BFC44,6'(! A 4  C((B 4 B> 4  4 D 4 14 ( 4 F ,'< 4  4 CB,'DB 4 ( 4 D 4 ,)B 4 '4 F ,B 4 C  DB( 4  4 D( 4 6ECB'@ 4 C  '@! 4 99#! 4 D'(B'( 4 2,'( 4  4 D(4 F)BC'W (4,DBB*'(44(DCB*'(4(4(C()D(44D4F'>B(4,B((,4 4D4 C((B4B>! A 4  C((B 4 B>4 ,6K4 D(4 ('D( 4 PC (4 ,FC 4 ' 4 BFC 4 ('(LC'C 4 4 CB(4>,4(4FDB(4'DCB*'(4((,B (49:6! D'(B'( 4 '( 4 (G,6 4  (FB( 4 ? 4 D',B 4 D( 4 B22 ,( 4  4  C((B(4 IB>(J 4 9D 4 ( 4 C((B< 4 AA 4  4  C((B(4IC ,,(J 4 9DE 4 (4  C((B<43A!4AG '4G1DFB44D!44566%49:744,FC 4D42 *',4(4 FDB(4,  )D(4FB((44 >B,4C4DG.4,6K4:74CB(4FCDB((4D(4 ,BH(44 C((B4FD'4'4A-L.B<445"4AA445943A<44%"4CB(4 ,ED ( 4  C'>'( 4 4 ' 4 C)DHF 4 >(,'DB! 4 A( 4 CB( 4 >, 4 ' 4 AA4 C (B4CD'(44D (B(4>(,'DB(4*'4D(4'@4'(4C'C(!4/4 ',B4'4 >D'F 4 ' 4 D) 4 2D 4 B 4 B 4 CDF 4 FB( 4  4 >B, 4 ,6K 4 ,( 4 CB(<4 (C,B>F44$R4C4CC4'@4 FB(444:<;R4C4CC4'@43A!4A(4 ''( 4 ,,D' 4 *'G' 4  ,@B 4 ( 4 ,B,'B( 4 2L('(L,B,'@ 4 (B4 BFCDB*'  4 ( 4 D 4  C((B 4  4 *' 4 ( 4 FB2B,B( 4 (','DD( 4 ' 4 ,>'4

D'B 4 ' 4 ED 4 CB,'DB 4 ( 4 D 4  C((B 4 B>! 4 3 4 >,6 4 ','4 FDB(4G4  4 4'4B>'4'4D)42D4C',6!

4C'4 CDF4,B 4DG '422,' 4C 43,44G7B44566%49:5<4*'B44 ,6,6 4 (GBD 4 @B(B 4 ' 4 ED 4 2>B( 4 ( 4 > F( 4  4 >B 4  4 ( 4 2,'(4 C(E,6(,B'@ 4  4 3A 4  4 AA! 4 AG6EC6H( 4  4 DG ' 4 B 4 *' 4 ,( 4 2,'(4 D'B4'4ED4CD'(4BFC4(4D(43A!43DD44,FC 4564CB(4PC (43A<4 %%4CB(4AA44%$4,ED(!4A(4''(44'> 4*'4D(4 > F(44>B 4 EC4'BD4 B4(BCB2B,B>F4CD'(42 *'(4,6K4D(4CB(43A49:5R4*'4 ,6K 4 D( 4 AA 4 97;R< 4 CY6<67 4  4 D( 4 ,ED( 4 995R< 4 CY6<6:! 4 A 4 ,,D'(B 4 (4 ''( 4  4 DG ' 4 B 4 *' 4 D( 4 3A 4 (B 4 CD'( 4  4 CC 4 >, 4 ( 4 2,'(4 C(E,6(,B'@<4D(4*'4(42,'(4')BDCB*'(42>B(B4D(4AA! 1B(B44C'4B((4'4DB44D4 C((B44D(422,B(4CB*'(4,  )D(!4 A4  C((B4  ,'4C'B 4 =4  D H4C'4 ,B(4  CB(4 ,  )D(4 4 >D'4>(4(4C (B(44CD'(44CD'(4 2B,BB(!414DGB>(<4D4('>'4 G'4 C((B4B>4C'B4'>4(4BCB4'4(42,'(42>B((4(4 D4C (,44FB2B,B(4,  )D(4DB (4'4>BBDDB((F4'4'@4C6DCB(4*'B4 D'B4(4((,B (49,24B45<4..L4B2B,B(4(','D(4,  )D(4DB (4?4DPC! 7B4*'4D(4 '(4(B4,B,B(49:%<:9<4D(4CB(44,FCB(4>,4 ,'@4E4'4'4 )'4C ,,44D4FDB<44FB(4 , (42FBDB'@44 ')D 4  4 D6'F'< 4 ' 4 C >D, 4 CD'( 4 D>  4  4 (EF 4  FBD< 4 CD'( 4 4  2B,B,(4'4(4'LC(E,6DCB*'4<4'4'@4CD'( 4 D> 44 >DCCF44  F, 4 (' 4 D 4 ('B>B< 4 ' 4 CD'( 4 C 4  2B,B, 4 'L((BDD< 4 ' 4CD'( 4 C4 DCB((F 4 ( 4 >B,'D( 4 ,  )'@ 4 D '@ 4  4 CD'( 4  4 (')(, 4 )D,64 6ECB(4?4DBFCB49::<:;<:"<:$! ACH( 4 DG '(4  4 ,4 3Z 4  4 566% 4 95"< 4 DGCCBB 4C ,,4 ' 4 C((B4 C'B 4 =4 ' 4 2,' 4 4 B(*'4C' 4 D4  C((B 4 B>< 4  4 ,B)'4 ?4 (4 FDB(4,  )D(4*'B4C B(C(4?4D4 C((B!4/4D4F ,B(F4BFCDB*'4(4 6F(4DB (4'4(((4*'B4,'B(4?4'4 ',B44D4( , B4'42,'4 'C<442BDF4'4BFB'B44D4'C H(4'4B>'4'4E'4 4 4DG6BCC,FC! %:

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

1'8*8'8#!0%8!8!8"!8"8!8!G+#8 ,"'K8 ACH(41D@C'D(4566:49;7< %"

9"#8'%"8%8"8

!+8

L45ECF )DB(F4(4(','(4,B,D4 (D( L45ECF )DB(F4(4(','(4 DBF)B*'4>D

2'%",%8

L41FDB(4(','DD(4+,B,'B4 2L(BD<4FECD444 D6BCC,FC L41 , (42FBDB'@

1"'8%&'8

LBBBDDB((F4,  )D4FD LDB(4DB (4?4DPC4+4 1 B(,D (<,BC6B(<&')D(4 BFF'DCB*'(44B2DFB( L C((4DD(B*'4'@4B22B,'D (

D++'%8G$)

"%

3)86',%8!8%"8!#"P8D8"

A4 FB>B 4(4'4C)DHF4FD'4,6K4D4C(4PC <4(''4D(*'4D4 2CBDB <4D4 C((B4'4D4 F,4CCB((!43DD4,FCDB*'4>B4,FCF4 D4CB(44,6C4(46B,C(4DB (4?4DPC!4 A( 4  4 >BD 4 DD 4 (4 CB,'DBHF4  4 DB 4 >,4 D( 4 ')D( 4 ,CBB2(4 *'4 C'>4C (4(4CB(4PC (4 CBF (!

.)6',%8!8%"8!#"

A4FB>B4(4C (4'4D4>B<4CB,BC4?4DBFC4,CBB>44D4C(<4 ?4DBFC44(B4B'BB><4)PB4('4(4(CBB(44(4 (B(!4A4,B4>B4?4 D4B4B(B(,4(4D,B4),6 4('4D4 D<44>D 44C 4D(4('B(4 '4,B4BBB <4(CB4,'B442B4)'B4'4CD4 ,B 49;5! A 4  FB>B 4 ( 4 2 *' 4 ,6K 4 D 4 14  4 C(( 4 >DB( 4 BCM'< 4 , 4 *'B4 @CDB*'4*'DD4(B4B('22B(FF4CB(44,FC!43DD4C'4('>B4('4'4B4  C((B2! 4 3DD 4 (BB*' 4 >, 4 D 4 >BBDDB((F 4 2D! 4 A 4 CD'(< 4 ( 4 C)DHF(4 (FB*'( 4 B2H 4 >, 4 D 4  FB>B! 4 A( 4 C)D FB*'( 4 C(E,6(,BD(4 (BB*' 4 >, 4 D( 4 C)DHF( 4 F B,'@ 4  4 D 4 2 *' 4 C 4 'FB<4 F'DB2,BDD<42B,BH<4DBDD<4C6E(B*'44C(E,6DCB*'!4A(4C6DCB(4 BC'[(44,6B*'(4('>B44224('4244C4'FB<4*'B4,F)B 4 '@ 4  (>C( 4 (,B'@< 4 ,(B' 4 D 4 6B,C! 4 ' 4 ' 4 D 4 D' 4 C'4 D'FB 4  4 ( 4  ('F 4 C( 4 ? 4 D 4 ,(FFB 4  4 (B( 4 C' 4 ,6CC 4 ? 4 D4  C,<4F=F4(B4D4CB(4(,BD<42FBDBD442B,B4(4,D4(4D4,4 C  D44D4CB(44,6C! A4 FB>B4(4'4C)D FB*'4,D4C DCB*'!43DD4('>B4F=F4  4 D)(, 4 4 ')D( 4 ,CBB2(< 4 DD 4 ( 4 ' 4 6B,C 4 FD' 4 *' 4 ,DDL,B 4 (4  C4'46B,C 4,4DD4'B4DB>(B((F4'4CD44(B<4,2B4 D4C(4(4'4('FB((B4?4'D'(4CD'(44 C,444 (>C! .D4@B(4'@ 4EC(44 FB>B 4(D 4A,B49;%<4 D4 FB>B4BB(H*'4 4 D4 FB>B 4 @B(H*'! 4 A 4 CFBH 4 >B 4 ? 4 ' 4 )D 4 B 4 ,FF 4 (', 4 4 D@,BB4+4>D'(4'4 (B<444*'BD4('CC4D4 DB(B4'4)(B4'L  FBB!4A4(,4>B4?4'4 2 ,4@ B'4+4)(B4 >B4*'D*' 4

,6(44 (C )D4'4)(B4=4 ,FC( 4C4*'D*''!4A4FB>B4(4 (B 4 ' FB 4 L 4 ,(4 D4 C(4 *'B 4  ,B 4 L 4 (B4 DD 4 (4 4  FBB4 @ 4 + 4 D 4 C( 4 ( 4 B2D',  4 C 4 ' 4 B(< 4 *'BD 4 (B 4 C ( 4 ' 4 )(!4 3  DF 4 D( 4 FB>B( 4 B( 4 ( 4 ' FB ( 4  4 D( 4 FB>B(4 @(46  L FB (! A' 4 CB 4 'C(E,6DCB*'< 4 D 4 FB>B 4 2B 4  4 ('DF 4 B>B 4 D4 ,CBB 4 9DE( 4 ' 4 C((B)D 4  4  4 DB =< 4 ,FC 6(B 4 ,(,B 4  4 D4 (B'B 4 ,'DD\< 4 4 D 4 ,B 4 9>D 4 4 2B< 4C( > ,4 (4 D,B!!4 FB(4'((B4)B4'4D FB49CDB(B4B,BC <4>B<4\!4.D4(CB4B(B4'4  DB 4 ,FCD@< 4 ? 4 D 4 2B( 4 ,FCF 4  4 C,(('( 4 2B( 4 B>B< 4 H(4 (,6 FB*'F<4D4D)42D<4D(4E'@4FECDB(<4D4(B'F4>D44D4 ,>'4((,BB2!4 A(4(BC(4D(4CD'(4,D((B*'(4?4,(B 4(4DBB22 ,422,B><4BDD,'DD<4  4 ('' 4 DBB22 , 4 '@ 4 ,6,(< 4  D? 4   4 C 4 3(*'BD< 4 *'B 4 (((,B 4 ? 4 '4 )DB(B44D 4,'D<4'4 (C()BDB(B+4D4C(4PC 4 C4 I)B((4D(4)(J!4A@F4,DBB*'4B4 CDF4(E( FB*'F4,6,64(4 C6DCB(4CB*'(4?4B(*'44')D(4FB>BD(444C4,B>B (4(4 D4*'BB! A4 FB>B4(42 *'4(4,(4,B,(,(4+4 2B,B(4,CBB2(<4CDE(B<4 BFB'B 4 4CD'( 4  4 76 4 NC 4C 4 CC4 ' 4CB( 4 B D< 4  2FB( 4B,'DB(<4  2B,B(4>B('D(! A(4C6DCB(4BCH(44D(4')D(4F )DB*'(4(C()D(44 FB>B4 (4+ 4 D(4'DCB*'(4(''4,'@4*'B44'4224( B2 4 D 4 ,(FFB4 ,6B*' 4  4 )KBK CB(< 4 D( 4 )=)D*'( 4 C'>4 (,,FCC 4 (6 B 4 ,6B*' 4  4  4 >B 4 ('> 4 2BC' 4 ( 4 D(4 )(>B(4'4BC(B,44](EF4C(' C((B2^ 4 /4(EF44(24+4D4CB4(4('>4 C 44B,C)D44 F )DB(4D4(((4B'B4C4D4,6CF4)'D44FB,BD4'44(>B,! 4 A6EC FB 4 D4 (6EB 4 D4E(6EWB 4 D6ECC6EWB %#

A4 FB>B44DC6B4,6K4D414C'B4=44CD'(44CC4>,4(4 D B( 4  4 ,B,'B( 4 CFBCB*'( 4 ('(L,B,'@< 4 , 4 *'B 4  4 ,FC 4 4 DC6B4(4D4FDB44NB(<4B(B4*'4(4,B)D(4,6DBCB*'(4,B,D(4 4DBF)B*'(4@CDB*'4D(4')D(4@ ,'B2(!4 A4FB(44 >B,4'4 FB>B<4,,FCC 44')D(4@ ,'B2(<4C (4 ' 4 BB(,')D 4 B = 4  4  4 *' 4 C((B)D 4 CF 4 ' 4 (EF 4  C((B2L E(@ ,'B2< 4 ' 4 ' 4  4  FBD 4  )'< 4 D( 4 F=F 4 *' 4 F*' 4 D 4 CDB4 F FB! 3 4 ,DBB*'< 4 BD 4 C' 4 = 4 'BD 4 '((B 4  4 (B 4 B('F( 4  4  CB(C< 4 DD4 D ,6DD 4  4  FB>B 4 931A 4  4 46B 4 9;9< 4 >DB  4  4 2MB( 4 ,6K 4 D(4 C((4PC (4 F(4'4<4*'B4@B(44>(B 4,'4?4*'4BF(49424 @45! A31A 4 ( 4 C ( 4 ,FF 4 ( 4 ,6DD( 4 ? 4 C((B 4 BB, 4 ( 4 )( 4 (' 4 '4 )4,B((,4(4CB(444D'4F44>B!4'4,4 ,6DD44*'BK4 BF(<4D(4 C((4>B44H(4('><4('><4C2B(44DFB(4_4D4(,4('BD 4 (44%"<44BD4(4C((B)D44D42B4C((4>,4DB44D42FBDD4D(*'4D4CB4 (4C(4('22B(FF4,'44D *'BC! AB>B4'C(E,6DCB*'492.444'FFBC(49;:4,FC4B22 (4B(4 DB2(4'@4(EFCEF(4 CB2(<4CB(4C4)4(4(4B>B4C6B<4,4 B4'BD4 4C(BB 4,FF4'BD4 >D'B44DC6B4(4D4FDB4 1DK6BF<44NB(44D4FBD4,CBB>4BFCBF!44FF4'(4DD(4D4  BDD4CD'(4DB<4BD4 >D'4D F'((F422,B24?4,E 44D4C4BBBB>444 D4C4B =44*'D*'(4*'(B(4(BFCD(!4 A 4  FB>B 4  4 D 4 1 4 ( 4 F'DB2,BDD4+ 4 C)D FB*'( 4 C(E,6(,BD(<4 C)DHF(4F B,'@<4C4'FB! A 4  FB>B 4  4 D 4 1 4 ,(B' 4 ' 4 EFB*' 4 ,*'B( 4  4 CCB( 4 4  ,(',B44D D4FB>BD4C4D4,2B4FH44G'4,E 4'4 'FB4*'B42D ,6B444DG'4'4 C,4*'B4G(4C(4,,C !4A(4,4 F)B>D,< 4 ( 4 C)D FB*'( 4 C(E,6(,BD( 4 CC> 4 D( 4 ,( *',( 4 (4 FDB(49;5! 4A4 FB>B4B22H4'4')D44D6'F'4CCF4B44 ,(B'4'4F*''44D4 C((B<4B(B4*''4C4 4?4D4 C,!4 A 4  C((B 4 BBBDB(  4  4 CC>  4 C 4 D 4  FB>B 4 BFC( 4  4  2BB 4 D(4 DBFB(44DB(B4(4D42FBDD444D4DB4(BCL(BC !4A4 C,4 (,BD44D(4,(4 C((B>(4 ('D44,4(B'B44 D) !

A( 4 ( CB( 4  4 (B 4 *'B 4 ,6,6 4 ? 4 >B 4 ' 4 CDDB 4 , 4 FC'B 4  4 D4 C(DB 4 ( 4 ' 4 ,`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

18)D8"

A 4 ,B 4 ( 4  2BB 4 ,FF 4 D 4 C,(('( 4 FD 4 *'B 4 ,B> 4  4 Q 4 ' 4 B 4 D4 ,FCF44DG,B!4A(4B>(4F(4'BDB( (4C'4C (4,B(4(C,(4  4 D 4 ,B 4 ,FC4 D4 FB>B 4 BB(H*'< 4 DGBB 4 >( 4 ' 4)'< 4 D4 >D <4D4>D <4DG'LB,B<44DG'L C'DB!4 3DD4',64D(4C((4H(4PC 4('>4'4D?44$:4(!43DD4(4, 4('4D4  FB>B<4*'4'(4>(4 BDD 4?4DGB(! A414C (44'4 (CCF422,B244DBD<4'4(BF4B'BDB <4'4 ,F 4 *'B 4 B 4 ( 4  CDBC,( 4 >( 4 DDLF=F< 4 ''B 4  4 (4 >BF!49;; A4 C((B 4,B>4(4F*' 4C4'4C44D4>D <44DFMC44 D,B44C4'4C4C6B!444 C((B44(C()D4'4 C,4 4CD'(44CD'(4BFC! 1B(B4,(4'42F42 *'FF4'> 44B(B'B!4A4144D(4E'@4*'B4 2B@ 4 D 4 F'< 4  4 D 4  CD, 4 ' 4 ,6B( 4 ? 4 D'< 4 DD 4 ( 4 ,BD< 4 C((B> 4 ((4 BBBB>44D6 B4(4('>4C (442M4BFC!4 43DD4(a2F4 CC((B>F4(4'4B(DF4,B((44C'42BB4C42'(4DB4F B,D!4 4CD4 CDF44I(EF44 (B>(B((FJ<4>4D4 (CCF4 22,B244DBD! .D 4 2' 4 DBFB 4 ' 4 C6DCB 4 CB*' 4 ((,B  4 9 CD(B< 4 22,B 4 'L  C  B2\ .D42'4C'4D4B22 ,B44DC6B4C'!49;;

6)82"$

AC6B 4 ( 4 ' 4 ')D 4  4 D 4 FB>B< 4 T 4 ( 4 FB2(B(4 ,FCFD(<4 FBDD(44,CBB>(!4 AC6B 4 ( 4 ' 4 ')D 4 2 *' 4  4 C(B( 4 ( 4  4 F)'(( 4 C6DCB(4 ' C  B>(!4 3DD4(4,, B(4((BDDF4C4'4C4B =44'4FB4CB,BCB4 '@4,B>B (46)B'DD(<4'4F*'4BBBB><4'4,4?4D)4C F' 4 (4,B>B (4F (<4'4BB22 ,4?4(B44'@4'(4B(B4*''4 F'((F4 22,B2!4A'4CB44>'4')BDCB*'<4DC6B4 ('D4'4E(2,BF4

( 4  CB( 4 2D( 4 (B 4 C 4 D (B 4 B,< 4 (B 4 C 4 D (B 4  4  CB( 4 E 4 (4 B,@B(4 ,BC*'(4>,4D4D)42D!4A(4,B,'B(4)(L6DFL,B,'@4 (F)D4CB,'DBHF4BFCDB*' (! .D 4 (CB 4 ' 4 ')D 4 ' 4 ,FCF 4 2 *' 4 ( 4  4 F)'(( 4 FDB(4 ' C  B>( 4 9FDB( 4 1DK6BF< 4  4 NB(< 4  4 5'BC<4  C  (,,(4D)B(42LFCD(!4-'>4,(B  4,FF4D4(EFCEF4 '4 C((B4'4'4 ,DB4,CBB2<4BD4(4'D'6'B4,DBF4FB(4*'DD4 @B(444*'4(EF4B(D 4,6K4'4,B4F)44CB(49;"!4 3422<44('DF4,(4'@4(EF(4,@B(4('><4FB(4BD4@B(44CD'(4 '4,B4,'>F4( FBDCB*'!444C@BFB 4C'4(@CDB*'4'4CB44 >'4C6E(BC6DCB*'4C'B(*'4,(4(EF(4 ('D44D4C')B44,B,'B(4 2,BD( 4 @=FF 4 DB (! 4 A' 4 C@BFB 4 ' 4 B>' 4 ('(L,B,D 4 ,,T 4 D4 C))BDB 4 *''4 D (B4 22,4CD'(B'(4 ,B,'B(4 4 4 DB' 4 ?4 ( 4 @C((B(4 ( FBDCB*'(4CD'BDD(49;$! 4C< 4 D 4 ,2'(B 4 C>B 4 '((B 4 ' 4 2B 4 *' 4 D 4 CD'C 4 ( 4 ,6DD( 4 4  C((B 4 ,B 4 ( 4 BF( 4 C 4 (' 4 ( 4 (EFCEF( 4 ,FF'( 4 '@ 4 '@4 (EF(44,(BH4DC6B4,FF4'4(BFCD4FB2(B44D4 C((B!4 <4(B4,B(4(EFCEF(49D4C4B =<4D4F*'4BBBB><4D4B4(,BD4 (4,FF'(4'@4'@4,BB(<4BD4@B(4'((B44,DB(4B22 ,(44C6B4 4 C((B49;#!4A(4(EFCEF(4E(C6B*'(49B(((<4(BF44,'DC)BDB <4  >DB(B<4C4(CB<4B (4('B,BB(4,, B(4D4 C((B2 4D(4*'4 DC6B*' 4  4 FB2( 4 C( 4  4  C( 4 FBDD! 4 A 4 C 4 B = 4 ( 4 D4  C((B4(4C  DF4DB 4'4(BF44 ((CB44'4C((BFB(F<4,4*'B4 (4C(4D4,(4(4DC6B4U4BD4@B(4'4BFB'B44DBFC,4,, 4?4 (4FB(4,FF4D4(,BDB(B<4D4C',B>B <4DBBBB>4'4D4C( > ,!4 A4 >DB(B44D(4C( (4 CB>(4?4CC(44D>B4(4,FF'(4(4D4  C((B 4 D( 4 *'DD( 4 ( 4 )(( 4 ,6K 4 DC6B*' 4 *'B 4 ( 4 F 4 CD'E4 BB22 ! 9%

A(4FB2(B(4,DBB*'(4(C ,B2B*'(4?4DGC6B4(4+4DG)(,44FB>B<4D4 F*'4BBBB><4D4 ',B4(4 C((4 FBDD(<4DGBB22 ,<4D4B4 (,BD44DG)(,44C( > ,! A( 4 (EFCEF( 4 CC( 4 ? 4 D 4  C((B 4 ( 4 + 4 D 4 B((( 4  4 DG6'F'< 4 D( 4 B (4 ('B,BB(<4D4 >DB(B<4D(4(BF(44,'DC)BDB <4D4C((BFB(F<4D(4B (4 B(44D4C4CC B! 1D( 4 *' 4 D( 4 (EFCEF( 4 ,FF'( 4 ? 4 DC6B 4  4 D 4  C((B 4 ( 4 + 4 D 4 C4 B =< 4 D 4 DB((F 4 C(E,6F'< 4 D 4 2BC'< 4 D 4 C 4  CB<4 DG6EC(FB<4D4F*'44C(CB,,B 44D4C4(CB! A( 4 D( 4 FDB( 4 'L C  B>(< 4 , 4 ( 4 D( 4 FB2(B( 4 ,FF'( 4 '@4 '@4(EF(4*'B4FH4('>4?4C4D4BC(B,44 C((B4FD'4 D( 4 F=F 4 *' 4 D( 4 FB2(B( 4 E(C6B*'( 4 ( 4 )((< 4 T 4 '4 ('(BFB4(4(EF(4 C((B2(4(4,(4CC'DB(! A'BDB(B4 ,6DD(4C (<4CF4'4 >D'B4( C 44DC6B444 D 4  C((B< 4  4 CFB( 4  4  F 4 ' 4 ,B 4 B C, 4  4 C6B 4 4  C((B!

A 4 )' 4  4 D.>B 41C6B 4 9.1 4 9"6 4 ( 4  4 ,'BDDB 4 ( 4 B2FB( 4 (' 4 D4 C (,4C6B4,6K4(4CB(4('2244C6DCB(4,  )D(!4A(4,BH(4 (4 ,B(44@4%!4A(4B(4BF(B(4 >D' (4(4+ L4F'((F422,B24<4C4BBBB><4C4B =4! A.14,FC4B(4>(B(! L 4 A 4 >(B 4 ,,FCC 4 ( 4)( 4 (' 4 D( 4  C(( 4 )'( 4 ' 4 ,,FCC4 B2F <44C 2 ,4>B>4>,4D4CB!4.D4(CB44D >D'B44 2 ,4 'BDB( 4C4D4CD'C4(4 ,6DD(4 >D'B4(4,FCF(4,6K4D4('D4PC ! L4A4>(B4CB49,24@494CF4)B4B,F4D>B(4'4('D4('4D(4 F=F(4FB(!444EC4'4 >D'B4(4FB(4,'4(4D(4,6,6(4 ,DBB*'(4FB(4CF4,C4)B4B,F4D>B(4'4('D! L 4 A 4 >(B 4 (BC4 ?4C' 4 )D,B24 4  4 ' 4 ,DBB,B 4 (4 CH(4C' 4 (4 >D'B44CF4'((B4)B4'4 >D'B4(4(4(B'B(4'4D >D'B4 4D,,FCC4(4C(4B(CB)D! 2'( 4 DG>(4 'BDB( 4 ( 4 4 '4  4 2B()BDB 4 C' 4)B 4 D 4B22 ,B 4  4 D4  C((B!

A 4 ABDD 4 C6E 4 BC 4 (,D 4 9A1- 4 9"7< 4 4  4  >DCC  4 ( 4 D)D,B24 CC 6 4 D( 4 BF(B( 4 ,FCFD< 4 ,CBB> 4  4 FBDD 4 4 DC6B4B(B4*'4D4CB(44,(,B,44(B44''B49"54D(4'4B4 (',' 42B4CBFB(4D4(B(B44D ,6DD!4A4CB4(4 > D4C2B(4 B,C)D4 >D'4((4')D(<4'4>(B4(B 4?4DB4D4CD'(4C,644  4  >DCC 44>DB 4(4'4(,4FC(49"%! .BBDF 4  >DCC  4 C' 4  CB( 4  4 >D' 4 DC6B 4 ( 4 D 4 FDB 4 4 NB(<4D4ABDD41C6E4BC4-,D4(4((BDDF4'BDB( 4(4,4FB!4 &'2B(< 4 ( 4 'BDB(B 4 (  4 CC((B>F 4 ? 4 '( 4 C6DCB( 4 9FDB4 1DK6BF<4(,D (44CD*'(<4FDB445'BC!43DD4(FBB(4D(4'4 B4(',' 4>,4D4CB49A1-4'4D4CB,BCD4B49A1-B! A(4D4FDB41DK6BF<4964?4:64R4(4CB(4(4C6B*'(<4D(4*'BD(44 (4*'>B4764R4?4 C'>4'4 4 C((B24FD'!4A(4 (4 C((B2(4(B4 '4,B4CD'(42 *'(4(4D(4FDB(44NB(4'445'BC!9"9 A(4'4F LDE(<4DG *'BC44B4N'F44D!49":<4(BCD4'4,F)BB 4 4C6B44 C((B4',6445644$%4R4(4('D(4(D4D(4 '(44'4 CCB 4  4 ('D( 4 ('22 4 C6B 4 I 4 C' 4 J 4 >B 4  4 75 4  4 %6 4 R! 4 44 9: