The dependent variable in all studies is either a symptom sumscore, or the categorical distinction between depressed and healthy. In both cases, potentially CYT 11387 important information about symptoms is lost, and a closer examination of these symptoms is likely to reveal important insights hidden by analyses of sumscores. In the present study, sleep onset insomnia had comparably strong impact on functioning in the domain of work. It has also been established that MDD treatment is less effective in patients suffering from sleep problems, that patients with persistent sleep problems are more than twice as likely to remain depressed, and that targeting sleep problems in patients diagnosed with MDD increases overall depression improvement. This example elucidates how clinically useful symptom-based approaches can be: they provide detailed information about the nature of problems individuals suffer from, and thus offer the opportunity to improving MDD prevention and treatment. In addition to studying individual MDD criterion symptoms of depression, it is important to acknowledge that the current DSM symptoms are but a small subset of possible depression symptoms, and were determined largely by clinical consensus instead of empirical evidence. Several non-DSM MDD symptoms merit closer examination and should be assessed in future studies of depressive symptoms, because they are highly prevalent and associated with worse clinical outcomes. For example, studies found anxiety and anger/irritability to be present in more than half of the patients diagnosed with MDD, and while remission of MDD was less likely and took longer in patients reporting anxiety, anger/irritability was a clinical marker of a more severe, chronic, and complex depressive illness. Symptoms and impairment potentially reinforce each other and are thus likely to blur, especially in individuals suffering from chronic depression. Second, while subjects at baseline of STAR*D were not taking antidepressant medication, many participants reported other medical conditions for which prescribed medications might have affected symptom reports. Third, the bootstrapped CIs for the RI estimates are fairly large for a sample of 3,703 subjects, implying a moderate amount of model uncertainty due to the high number of regressors as well as substantial covariation between them. Fourth, item wording may have biased the associations of individual symptoms with impairment; in particular, because subjects were asked to rate the impact of their depression on impairment, sadness may be artificially inflated. To explore this further would require alternative question wording. Lastly, differential variability in depressive symptoms is a potential source of biased RI estimates, because heavily skewed symptoms with means close to the minimum and maximum are less likely to demonstrate pronounced statistical relationships. Honey has been known for centuries for its medicinal and health properties. The quantity of these components varies greatly according to the floral and geographical origin, processing, handling and storage.