Limitations
first-episode depression, depression
This study has several limitations. First, symptom fluctuation was evaluated retrospectively using the VAS tool, and the definition of FAD was empirical without a reference standard, which may have introduced bias and affected data accuracy. However, proposing a definition of FAD was fundamental to the needs of clinical practice. An improved definition of FAD in the future requires adequate support of higher-quality evidence. Additionally, another potential weakness of the study was its small sample size in a single center, which may limit the generalizability of the results. What is more, including patients with first-episode depression and patients with recurrent depression in the sample may limit the internal and external validity. Furthermore, collecting data during the COVID-19 pandemic may have impacted the results of this study. Additionally, a significant difference in dissociation levels at 40 minutes was observed and blinding assessment was lacking, which could potentially affect the integrity of blinding.