Anhedonia is associated with blunted reward sensitivity in first-degree relatives of patients with major depression.
Anhedonia is associated with blunted reward sensitivity in first-degree relatives of patients with major depression.
复制标题
重度抑郁症患者的一级亲属的快感缺失与奖赏敏感性减弱有关
DOI：
10.1016/j.jad.2015.10.050
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发表时间：
2016-01-15
影响因子：
6.6
通讯作者：
Chan RCK
中科院分区：
文献类型：
--
作者：
Liu WH;Roiser JP;Wang LZ;Zhu YH;Huang J;Neumann DL;Shum DHK;Cheung EFC;Chan RCK
快感缺失是严重抑郁症的一个基本特征，并被认为是由低动机，特别是迟钝的奖励敏感度引起的。它被认为是代表这种疾病的遗传易感性的一个标记。然而，对于重度抑郁症患者未受影响的一级亲属的风险增加的潜在机制，人们知之甚少。我们之前在急性抑郁症患者中发现了不正常的奖赏偏向。本研究旨在探讨重度抑郁症患者一级亲属奖赏偏向的发展。纳入重度抑郁症患者一级亲属47例(女性26例，年龄18~52岁)和无抑郁症家族史的健康对照组60例(女性34例，年龄21~48岁)。一项随机奖励的高难度视觉辨别任务被用来评估钝化的奖励敏感性。对奖励更频繁的刺激的反应偏向(称为“奖励偏向”)是这项研究的主要结果变量。参与者还完成了自我报告的快感缺乏和抑郁症状的测量。与对照组相比，有亚临床抑郁症状的重度抑郁症患者亲属表现出钝化的奖赏偏向。没有症状的亲属在自我报告和实验测量上都表现出基本完整的动机加工。在重度抑郁症患者的一级亲属中，快感缺失的程度与减弱的奖励偏向有关，特别是在那些有亚临床症状的患者中。这项研究没有包括抑郁症患者组，这限制了我们解释观察到的组差异的能力。迟钝的奖赏敏感度可能主要表现在有高度抑郁症状的亲属中。
Anhedonia is a cardinal feature of major depression and is hypothesized to be driven by low motivation, in particular blunted reward sensitivity. It has been suggested to be a marker that represents a genetic predisposition to this disorder. However, little is known about the mechanisms underlying this heightened risk in unaffected first-degree relatives of patients with major depression. We previously demonstrated abnormal reward biases in acutely depressed patients. The present study aimed to examine the development of reward bias in first-degree relatives of patients with major depression. Forty-seven first-degree relatives of patients with major depression (26 females, age 18-52) and 60 healthy controls with no family history of depression (34 females, age 21-48) were recruited. A probabilistically rewarded difficult visual discrimination task, in which participants were instructed about the contingencies, was used to assess blunted reward sensitivity. A response bias towards the more frequently rewarded stimulus (termed “reward bias”) was the primary outcome variable in this study. Participants also completed self-reported measures of anhedonia and depressive symptoms. Compared with the control group, relatives of patients with major depression with sub-clinical depressive symptoms displayed a blunted reward bias. Relatives without symptoms displayed largely intact motivational processing on both self-report and experimental measures. The degree of anhedonia was associated with attenuated reward bias in first-degree relatives of patients with major depression, especially in those with sub-clinical symptoms. The study did not include a depressed patient group, which restricted our ability to interpret the observed group differences. Blunted reward sensitivity may be largely manifested in a subgroup of relatives with high levels of depressive symptoms.