title: The relationship between symptom relief and functional improvement during acute fluoxetine treatment for patients with major depressive disorder.
abstract: BACKGROUND
  The purpose of this study was to compare the rate of symptom relief to functional improvement and examine the relationships between symptom relief and functional improvement during the acute phase of treatment.
  
  
  METHODS
  A total of 131 acutely ill inpatients with major depressive disorder were enrolled to receive 20mg of fluoxetine daily for 6 weeks. Symptom severity, using the 17-item Hamilton Depression Rating Scale (HAMD-17), and functioning, using the Modified Work and Social Adjustment Scale (MWSAS), were measured regularly. The outcome measures were the HAMD-17 score and MWSAS score at weeks 1, 2, 3, 4, and 6. We compared the effect size and the reduction rate of HAMD-17 to those of MWSAS at week 1, 2, 3, 4, and 6. Structural equation modeling was used to examine relationships among the study variables.
  
  
  RESULTS
  Of the 131 participants, 126 had at least one post-baseline assessment at week 1 and were included in the analysis. The HAMD-17 had a larger effect size and reduction rate than the MWSAS at weeks 1, 2, 3, 4, and 6. Parsimonious model satisfied all indices of goodness-of-fit (Chi-Square/df=1.479, TLI=0.978, CFI=0.986, RMSEA=0.062) and had all paths with significant path coefficients. MWSAS at week 0 predicted HAMD-17 at week 1.
  
  
  CONCLUSIONS
  This was an open-labeled study with small sample size.
  
  
  CONCLUSIONS
  Depressive symptoms improved more quickly than functioning during the acute phase of treatment. Depressive symptoms and functional impairment are distinct domains, and should be assessed independently.
authors.affiliation: Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, 130, Kai-Syuan 2nd Rd., Ling-Ya District, Kaohsiung 802, 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: Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, 130, Kai-Syuan 2nd Rd., Ling-Ya District, Kaohsiung 802, Taiwan.
authors.forename: Li-Shiu
authors.initials: LS
authors.lastname: Chou
authors.affiliation: Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, 130, Kai-Syuan 2nd Rd., Ling-Ya District, Kaohsiung 802, 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, 130, Kai-Syuan 2nd Rd., Ling-Ya District, Kaohsiung 802, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. Electronic address: ccchen@kcg.gov.tw.
authors.forename: Cheng-Chung
authors.initials: CC
authors.lastname: Chen
mesh_terms: D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D018687:Antidepressive Agents, Second-Generation; D005473:Fluoxetine
keywords: 17-item Hamilton depression rating scale; Fluoxetine; Major depressive disorder; Structural equation modeling; Work and social adjustment scale