Diminished effort on a progressive ratio task in both unipolar and bipolar depression.
Diminished effort on a progressive ratio task in both unipolar and bipolar depression.
复制标题
DOI：
10.1016/j.jad.2016.02.003
复制
发表时间：
2016-05-15
影响因子：
6.6
通讯作者：
Wolf DH
中科院分区：
文献类型：
--
作者：
Hershenberg R;Satterthwaite TD;Daldal A;Katchmar N;Moore TM;Kable JW;Wolf DH
动机，或果断快感缺乏，是抑郁症的一个显著的致残性特征。然而，抑郁症的这一方面仍未得到充分的研究，并且没有先前的工作在单极和双相抑郁症中应用客观的实验室动机测试。我们使用累进比例任务（PRT）来评估动机缺陷，该任务将努力获得金钱奖励的意愿指数化。PRT对96名年龄在18-60岁之间的成年人实施，其中包括25名目前患有单相抑郁症的参与者，28名患有双相情感障碍（目前患有抑郁症）的参与者，以及43名没有任何I轴精神疾病史的对照组。从递进比率断点的客观定义来看，抑郁参与者表现出明显低于对照组的动机。单极和双相组均低于对照组，但彼此之间没有差异。药物使用在各组之间存在差异，并且我们没有单独的控制任务来测量精神运动活动；然而，无论是药物作用还是精神运动减缓都不能解释我们的发现。我们的研究填补了文献中的一个重要空白，提供了证据，证明在经历单极或双相抑郁症的抑郁症患者中，PRT的努力都有所减少。这为奖励和动机功能障碍的共同机制提供了越来越多的证据，并强调了改善情绪障碍谱系中动机缺陷的评估和治疗的重要性。
Amotivation, or decisional anhedonia, is a prominent and disabling feature of depression. However, this aspect of depression remains understudied, and no prior work has applied objective laboratory tests of motivation in both unipolar and bipolar depression. We assessed motivation deficits using a Progressive Ratio Task (PRT) that indexes willingness to exert effort for monetary reward. The PRT was administered to 96 adults ages 18–60 including 25 participants with a current episode of unipolar depression, 28 with bipolar disorder (current episode depressed), and 43 controls without any lifetime history of Axis I psychiatric disorders. Depressed participants exhibited significantly lower motivation than control participants as objectively defined by progressive ratio breakpoints. Both the unipolar and bipolar groups were lower than controls but did not differ from each other. Medication use differed across groups, and we did not have a separate control task to measure psychomotor activity; however neither medication effects or psychomotor slowing are likely to explain our findings. Our study fills an important gap in the literature by providing evidence that diminished effort on the PRT is present across depressed patients who experience either unipolar or bipolar depression. This adds to growing evidence for shared mechanisms of reward and motivation dysfunction, and highlights the importance of improving the assessment and treatment of motivation deficits across the mood disorders spectrum.