<qa>  What is the cumulative Illness Rating Scale?Medical illness burden will be assessed at baseline and at exit with the Cumulative Illness Rating Scale CIRS, a valid and widely used 13-item, 0-4, clinician-rated scale that assesses medical impairment related to major organ systems. Medical history and review of systems is used for the rating. The scale will be rated by a study physician. The scale has been used in other recent antidepressant trials to assess medical illness burden. The Perceived Stress Scale PSS-10 is a 10-item, 0-4 self-report scale that assesses stressful feelings and thoughts in the past month. The PSS-10 has adequate reliability and validity and is a better predictor of some outcomes e.g. depressive and physical symptoms, utilization of health services, social anxiety than were life-event scores. The PSS-10 appears to provide a general appraisal of life stress. The PSS-10 will be administered at baseline, week 4, week 8, week 12, and at exit or if continued, week 28. 