Anhedonia in melancholic and non-melancholic depressive disorders

JOURNAL OF AFFECTIVE DISORDERS

卷:184

Article

Fletcher, Kathryn^1,2,3  Parker, Gordon^1,2  Paterson, Amelia^1,2  Fava, Maurizio^4,5  Iosifescu, Dan⁶  Pizzagalli, Diego A.^4,7 

[1] Univ New S Wales, Sch Psychiat, Sydney, NSW 2052, Australia

[2] Black Dog Inst, Sydney, NSW, Australia

[3] Ctr Psychol & Relationship Counselling, Melbourne, Vic, Australia

[4] Massachusetts Gen Hosp, Boston, MA 02114 USA

[5] Harvard Univ, Sch Med, Boston, MA USA

[6] Mt Sinai Hosp, New York, NY 10029 USA

[7] McLean Hosp, Belmont, MA 02178 USA

关键词: Melancholic;    Non-melancholic;    Depression;    Anhedonia;    Reward responsiveness;    Motivation;   

DOI  :  10.1016/j.jad.2015.05.028

来源: Elsevier

【 摘 要 】

Background: Anhedonia represents a core symptom of major depression and may be a potential marker for melancholia. However, current understanding of this construct in depressive sub types is limited. Method: Participants were recruited from the Black Dog Institute (Sydney) arid Massachusetts General Hospital (Boston). Diagnostic groups were derived on the basis of agreement between clinician and DSM-IV diagnosis from structured interviews. Currently depressed unipolar melancholic, non melancholic and healthy control participants were administered a probabilistic reward task (PRT) to assess a behavioural correlate of anhedonia-blunted reward based learning. Self reported measures of anhedonia, approach and avoidance motivation were completed by the Sydney sample. Results: Relative to healthy controls and non-melancholic participants, melancholic depressed participants had reduced response bias, highlighting blunted reward teaming. Moreover, although non-melancholic participants were characterized by a delayed response bias, melancholic depressed participants Failed to develop a bias throughout blocks. Response bias showed 110 associations with self-report measures of hedonic tone in depressed participants. Positive associations were observed between response bias, approach and avoidance motivation in non-melancholic participants only. Limitations: Possible medication, fatigue and anxiety effects were not controlled; small sample sizes; inclusion criteria may have excluded those with severe melancholia and led to underestimation of group differences. Conclusions: Melancholia is characterised by a reduced ability to modulate behaviour as a function of reward, and the motivational salience of rewarding stimuli may differ across depressive sub-types. Results support the view that melancholia is a distinct sub-type. Further exploration of reward system functioning in depressive sub-types is warranted. (C) 2015 Elsevier B.V. All rights reserved.

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