title: Correlates of residual fatigue in patients with major depressive disorder: The role of psychotropic medication.
abstract: OBJECTIVE
  Fatigue is not only a core symptom of major depressive disorder (MDD), but also a common residual symptom. We determined the sociodemographic, clinical, and pharmacologic factors that were associated with fatigue in patients with remission or partial remission of MDD.
  
  
  METHODS
  Data was derived from a randomized controlled trial of acupuncture in 137 MDD patients with residual symptoms. Fatigue was measured by Multidimensional Fatigue Inventory (MFI-20). Self-report and clinician-rated scales were used to assess psychopathology. 17-item Hamilton Depression Rating Scale (HDRS17) score≤7 denoted MDD remission.
  
  
  RESULTS
  Participants' average HDRS17 score was 10.5; 29.2% were in remission. The average MFI-20 score was 71.8; 83.2% had severe fatigue, defined as MFI-20 score≥60. Fifty-two of 137 participants (38%) were using sedating psychotropic medications. Antidepressant dosage ranged from 1-90mg fluoxetine equivalent and sedatives/hypnotics from 1-60mg diazepam equivalent. There were significant correlations between MFI-20 score and HDRS17 depression and anxiety subscores, Hospital Anxiety and Depression Scale (HADS) depression and anxiety subscores, and Pain Catastrophizing Scale score, but insomnia and daytime sleepiness, sociodemographics, current medical conditions, and psychotropic medication use were not significant correlates. Upon multiple regression, HADS and HDRS17 depression scores independently predicted MFI-20 score. In remission and partial remission subgroups, HADS depression score was an independent predictor.
  
  
  CONCLUSIONS
  Participants were recruited from specialty psychiatric units; hence the findings may not be applicable in non-specialized settings.
  
  
  CONCLUSIONS
  Fatigue was predicted by depression severity in remitted or partially remitted MDD. Psychotropic medication and higher dosage were not associated with greater fatigue.
authors.affiliation: Department of Psychiatry, The University of Hong Kong, Hong Kong SAR, China. Electronic address: kfchung@hkucc.hku.hk.
authors.forename: Ka-Fai
authors.initials: KF
authors.lastname: Chung
authors.affiliation: Department of Psychiatry, The University of Hong Kong, Hong Kong SAR, China.
authors.forename: Yee-Man
authors.initials: YM
authors.lastname: Yu
authors.affiliation: School of Chinese Medicine, The University of Hong Kong, Hong Kong SAR, China.
authors.forename: Wing-Fai
authors.initials: WF
authors.lastname: Yeung
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000150:complications* / Q000188:drug therapy* / Q000523:psychology; D005221:Fatigue / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D016032:Randomized Controlled Trials as Topic; D057566:Self Report; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology
chemical_list: D000928:Antidepressive Agents
keywords: Depression; Fatigue; Major depressive disorder; Multidimensional fatigue inventory; Partial remission; Residual symptoms