title: Depression and pain impair daily functioning and quality of life in patients with major depressive disorder.
abstract: BACKGROUND
  Depression and pain frequently occur together. The objective of this study was to investigate the effects of depression and pain on the impairment of daily functioning and quality of life (QOL) of depressed patients.
  
  
  METHODS
  We enrolled 131 acutely ill inpatients with major depressive disorder. Depression, pain, 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 using three primary domains of the SF-36: 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.
  
  
  RESULTS
  In all, 129 patients completed all the measures. Model 5, both depression and pain impaired daily functioning and QOL, was the most fitted structural equation model (χ(2)=9.2, df=8, p=0.33, GFI=0.98, AGFI=0.94, TLI=0.99, CFI=0.99, RMSEA=0.03). The correlation between pain and depression was weak (r=-0.27, z=-2.95, p=0.003).
  
  
  CONCLUSIONS
  This was a cross-sectional study with a small sample size.
  
  
  CONCLUSIONS
  Depression and pain exert a direct influence on the impairment of daily functioning and QOL of depressed patients; this impairment could be expected regardless of increased pain, depression, or both pain and depression. Pain had a somewhat separate entity from depression.
authors.affiliation: Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Ching-Hua
authors.initials: CH
authors.lastname: Lin
authors.affiliation: Department of Psychiatry, E-Da Hospital, Kaohsiung, Taiwan; School of Medicine, I-Shou University, Kaohsiung, Taiwan.
authors.forename: Yung-Chieh
authors.initials: YC
authors.lastname: Yen
authors.affiliation: Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Ming-Chao
authors.initials: MC
authors.lastname: Chen
authors.affiliation: Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. Electronic address: cchen@mail.khja.org.tw.
authors.forename: Cheng-Chung
authors.initials: CC
authors.lastname: Chen
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D003865:Major Depressive Disorder / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000523:psychology*; D011788:Quality of Life; D012917:Social Adjustment
keywords: Daily functioning; Health-related quality of life; Major depressive disorder; Pain; Structural equation modeling