Abstract:Anhedonia, a diminished or lack of ability to experience and anticipate pleasure represents a core psychiatric symptom in depression. Current clinician assessment of anhedonia is generally limited to one or two all-purpose questions and most well-known psychometric scales of anhedonia are relatively long, self-administered, typically not state sensitive, and are unsuitable for use in clinical settings. A user-friendly tool for a more in-depth clinician assessment of hedonic capacity is needed. The present stud… Show more
BackgroundBoth acute and chronic pain can disrupt reward processing. Moreover, prolonged prescription opioid use and depressed mood are common in chronic pain samples. Despite the prevalence of these risk factors for anhedonia, little is known about anhedonia in chronic pain populations.MethodsWe conducted a large-scale, systematic study of anhedonia in chronic pain, focusing on its relationship with opioid use/misuse, pain severity, and depression. Chronic pain patients across four distinct samples (N = 488) completed the Snaith–Hamilton Pleasure Scale (SHAPS), measures of opioid use, pain severity and depression, as well as the Current Opioid Misuse Measure (COMM). We used a meta-analytic approach to determine reference levels of anhedonia in healthy samples spanning a variety of countries and diverse age groups, extracting SHAPS scores from 58 published studies totaling 2664 psychiatrically healthy participants.ResultsCompared to healthy samples, chronic pain patients showed higher levels of anhedonia, with ~25% of patients scoring above the standard anhedonia cut-off. This difference was not primarily driven by depression levels, which explained less than 25% of variance in anhedonia scores. Neither opioid use duration, dose, nor pain severity alone was significantly associated with anhedonia. Yet, there was a clear effect of opioid misuse, with opioid misusers (COMM ⩾13) reporting greater anhedonia than non-misusers. Opioid misuse remained a significant predictor of anhedonia even after controlling for pain severity, depression and opioid dose.ConclusionsStudy results suggest that both chronic pain and opioid misuse contribute to anhedonia, which may, in turn, drive further pain and misuse.
BackgroundBoth acute and chronic pain can disrupt reward processing. Moreover, prolonged prescription opioid use and depressed mood are common in chronic pain samples. Despite the prevalence of these risk factors for anhedonia, little is known about anhedonia in chronic pain populations.MethodsWe conducted a large-scale, systematic study of anhedonia in chronic pain, focusing on its relationship with opioid use/misuse, pain severity, and depression. Chronic pain patients across four distinct samples (N = 488) completed the Snaith–Hamilton Pleasure Scale (SHAPS), measures of opioid use, pain severity and depression, as well as the Current Opioid Misuse Measure (COMM). We used a meta-analytic approach to determine reference levels of anhedonia in healthy samples spanning a variety of countries and diverse age groups, extracting SHAPS scores from 58 published studies totaling 2664 psychiatrically healthy participants.ResultsCompared to healthy samples, chronic pain patients showed higher levels of anhedonia, with ~25% of patients scoring above the standard anhedonia cut-off. This difference was not primarily driven by depression levels, which explained less than 25% of variance in anhedonia scores. Neither opioid use duration, dose, nor pain severity alone was significantly associated with anhedonia. Yet, there was a clear effect of opioid misuse, with opioid misusers (COMM ⩾13) reporting greater anhedonia than non-misusers. Opioid misuse remained a significant predictor of anhedonia even after controlling for pain severity, depression and opioid dose.ConclusionsStudy results suggest that both chronic pain and opioid misuse contribute to anhedonia, which may, in turn, drive further pain and misuse.
“…In this second phase of the experiment participants entered demographic information before completing the MacArthur Scale of Subjective Social Status (Adler, Epel, Castellazzo, & Ickovics, 2000), Beck’s depression inventory II (BDI-II, Beck et al, 1996), the Snaith Hamilton pleasure scale (SHAPS, Snaith et al, 1995) and the Holmes and Rahe stress scale (Holmes & Rahe, 1967). The SHAPS was additionally scored using the SHAPS-C criteria (Ameli et al, 2014) while for the stress scale participants were asked if each event occurred in either their adult life or the last year. For all stages of the experiment participants were instructed to use a desktop or laptop only and that they should be in a quiet place with minimal distractions.…”
BackgroundEarly life stress (ELS) is an important risk factor for the development of depression. Impairments in reward learning and feedback sensitivity have been suggested. to be an intermediate phenotype in depression aetiology. We therefore hypothesised that healthy adults with a history of ELS would have impairments in reward learning and feedback sensitivity.MethodsWe recruited 64 adult participants with high levels of ELS and no diagnosis of a current mental health disorder in addition to 65 controls. Participants completed two online reward learning tasks: the probabilistic reversal learning task (PRLT) and probabilistic reward task (PRT). Participants also completed depression, anhedonia, social status and stress scales with PRLT data being additionally analysed utilising a reinforcement learning model.ResultsParticipants with high levels of ELS showed decreased positive feedback sensitivity (PFS) in the PRLT compared to controls. High ELS participants also tended towards possessing a decreased model-free learning rate which strengthened in subsequent analysis. This was coupled with a decreased learning ability in the acquisition phase of block 1 following the practice session. Neither groups of participants showed a reward induced response bias in the PLT however high ELS participants exhibited decreased discrimination ability between stimuli; this was however accounted for by depression symptomology in further analysis.ConclusionsThese data suggest that healthy participants without a mental health diagnosis and high levels of ELS show deficits in PFS and reward learning in the PRLT that are distinct from depressed patients. These deficits may be relevant to an increased vulnerability to depression.
“…SHAPS is a well-validated, 14-item instrument used to assess anhedonia. Participants were asked to rate whether they agree, strongly agree, disagree, or strongly disagree that they would enjoy various experiences that are generally considered pleasurable (e.g., "I would find pleasure in my hobbies and past-times") with either of the Disagree responses receiving a score of 1 and either of the Agree responses receiving a score of 0 [15]. Thus, the SHAPS was scored as the sum of the 14 items, total scores ranged from 0 to 14.…”
Background: Anhedonia, is defined as reduced capacity to gain pleasure from pleasurable experiences, is a key symptom of major depression. Several studies had investigated anhedonia in schizophrenia and major depressive disorder, using different psychometric and radiological assessment tools with controversy results in either severity of anhedonia or radiological findings. The aim of this study was to differentiate the nature of the issue of anhedonia in schizophrenia versus major depressive disorder; from clinical and brain function part of view, and to study different variables in this regard.
Methods: This study was carried on 60 participants who were divided into three groups: Group 1: 20 schizophrenic patients, diagnosed according to DSM-5. The symptoms of schizophrenic patients must include anhedonia as a main symptom, Group 2: 20 patients with major depressive disorder according to DSM-5 criteria, and anhedonia was one of their prominent symptoms, Group 3: 20 control subjects.
Results: Our results revealed statically significant differences between participants as regards age of onset, occupational career. Statically significant differences were found between 3 groups. Most of patients in group 1 lacks the interest for social activities and intimate relationships. Statically significant Difference was found between patients in both groups compared to controls. Striatal activity (mainly caudate) was significantly diminished in group 2 (P value <0.001) and group 1 (P value 0.002) relative to controls. Prefrontal activity (ventromedial area ''vmPFC'' and dorsolateral area ''DLPFC'') was increased significantly in group 2 more than control group (P value 0.034). Group 1 shows significantly decreased activation than controls (P value 0.019). Significant differences were found between group 1 and 2 (P value <0.001). Orbito-frontal activity was increased significantly in depressed patients more than group 1 (P <0.001) and controls (P =0.019).
Conclusions: Anhedonia is a highly disabling symptom in patients with schizophrenia or MDD, associated with poor outcome. Depressed anhedonic patients have higher incidence of suicidal ideas, thoughts, and behavior. Depressed patients showed significant striatal hypoactivation associated with hyper activation of prefrontal and orbitofrontal areas. Schizophrenic patients showed diminished activation at striatal areas and frontal cortex. We fail to find significant correlation between severity of anhedonia in both patient groups and degree of fMRI activation in different brain areas involved in reward processing.
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