title: Relief of depression and pain improves daily functioning and quality of life in patients with major depressive disorder.
abstract: OBJECTIVE
  The objective of this study was to investigate the effects of depression relief and pain relief on the improvement in daily functioning and quality of life (QOL) for depressed patients receiving a 6-week treatment of fluoxetine.
  
  
  METHODS
  A total of 131 acutely ill inpatients with major depressive disorder (MDD) were enrolled to receive 20mg of fluoxetine daily for 6 weeks. Depression severity, pain severity, daily functioning, and health-related QOL were assessed at baseline and again at week 6. Depression severity, pain severity, and daily functioning were assessed using the 17-item Hamilton Depression Rating Scale, the Short-Form 36 (SF-36) Body Pain Index, and the Work and Social Adjustment Scale. Health-related QOL was assessed by three primary domains of the SF-36, including social functioning, vitality, and general health perceptions. Pearson's correlation and structural equation modeling were used to examine relationships among the study variables. Five models were proposed. In model 1, depression relief alone improved daily functioning and QOL. In model 2, pain relief alone improved daily functioning and QOL. In model 3, depression relief, mediated by pain relief, improved daily functioning and QOL. In model 4, pain relief, mediated by depression relief, improved daily functioning and QOL. In model 5, both depression relief and pain relief improved daily functioning and QOL.
  
  
  RESULTS
  One hundred and six patients completed all the measures at baseline and at week 6. Model 5 was the most fitted structural equation model (χ(2) = 8.62, df = 8, p = 0.376, GFI = 0.975, AGFI = 0.935, TLI = 0.992, CFI = 0.996, RMSEA = 0.027).
  
  
  CONCLUSIONS
  Interventions which relieve depression and pain improve daily functioning and QOL among patients with MDD. The proposed model can provide quantitative estimates of improvement in treating patients with MDD.
authors.affiliation: Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan; Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Nursing, Fooyin University, Kaohsiung, Taiwan. Electronic address: chua.lin@msa.hinet.net.
authors.forename: Ching-Hua
authors.initials: CH
authors.lastname: Lin
authors.forename: Yung-Chieh
authors.initials: YC
authors.lastname: Yen
authors.forename: Ming-Chao
authors.initials: MC
authors.lastname: Chen
authors.forename: Cheng-Chung
authors.initials: CC
authors.lastname: Chen
mesh_terms: D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology*; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008960:Models, Psychological; D010146:Pain / Q000503:physiopathology / Q000523:psychology*; D011788:Quality of Life; D012720:Severity of Illness Index; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D018687:Antidepressive Agents, Second-Generation; D005473:Fluoxetine
keywords: 17-item Hamilton Depression Rating Scale; AGFI; AMOS; Adjusted Goodness-of-Fit Index; Analysis of Moment Structures; BPI; Body Pain Index; CFI; CGI-S; Clinical Global Impression of Severity; Comparative Fit Index; DSM-IV; Daily functioning; Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; GFI; GH; General Health Perceptions; Goodness-of-Fit Index; HAMD-17; Health-related quality of life; MDD; Major Depressive Disorder; Major depressive disorder; Pain; QOL; Quality of Life; RMSE; Root Mean Square Error of Approximation; SEM; SF; SF-36; Short-Form 36; Social Functioning; Structural Equation Modeling; Structural equation modeling; TLI; Tucker–Lewis Index; VT; Vitality; WSAS; Work and Social Adjustment Scale