Overall depression severity was assessed by the MADRS total score.49 Anhedonia was assessed by means of the MADRS 5-item anhedonia subscale score, which was based on the following MADRS items: 1 (apparent sadness), 2 (reported sadness), 6 (concentration difficulties), 7 (lassitude), and 8 (inability to feel).6 Functional impairment was assessed using the SDS.50,51 This brief self-report measure assesses three functional domains (work/school, social life/leisure, and family life/home responsibility) over the previous 7 days. Patients rate the severity of impairment for each domain on a scale of 0–10, with higher scores indicating greater impairment. Scores from the individual domains are combined to generate the SDS total score, which ranges from 0 (unimpaired) to 30 (highly impaired). For all these scales, higher scores indicate greater impairment.

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