Does physical anhedonia play a role in depression? A 20-year longitudinal study.
Does physical anhedonia play a role in depression? A 20-year longitudinal study.
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DOI：
10.1016/j.jad.2009.05.002
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发表时间：
2010-01
影响因子：
6.6
通讯作者：
Faull, Robert
中科院分区：
文献类型：
--
作者：
Shankman, Stewart A.;Nelson, Brady D.;Harrow, Martin;Faull, Robert
身体或感官体验的快感缺乏症（即，身体快感缺乏症）通常被认为是精神分裂症与抑郁症的区别，尽管事实上，普遍的快感缺乏症是许多重度抑郁症（MDD）模型的核心特征。49名非精神病性重度抑郁症患者从住院环境中招募，并在20年内随访了6次。该研究的三个目的是评估a)身体快感缺乏症随时间的稳定性，b)身体快感缺乏症是否与抑郁症状的病程有关，以及c)身体快感缺乏症是否与三个功能领域有关——工作、社会功能或再次住院。我们发现，随着时间的推移，身体快感缺乏症相对稳定，并与抑郁症状相关（人与人之间和人与人之间）。身体快感缺乏症也与某些方面的功能有关，尽管不如抑郁症状那么强烈。由于在每次随访中同时测量抑郁症状、功能和身体快感缺乏，因此无法评估这些变量之间的因果关系。此外，由于我们的样本是从住院患者中招募的，我们的发现可能不适用于抑郁症较轻的个体。对于重度抑郁症患者来说，对积极的身体刺激的愉悦感降低是一个有临床意义的变量，也可能是一种更严重的抑郁症的行为内表型。
Anhedonia towards physical or sensory experiences (i.e., physical anhedonia) has most often been examined as a differentia of schizophrenia and not depression, despite the fact that general anhedonia is a core feature of many models of Major Depressive Disorder (MDD). Forty-nine participants with non-psychotic MDD were recruited from inpatient settings and followed-up six times over 20 years. The three aims of the study was to assess a) the stability of physical anhedonia over time, b) whether physical anhedonia relates to the course of depressive symptoms over time, and c) whether physical anhedonia relates to three domains of functioning – work, social functioning, or re-hospitalizations. We found that over time physical anhedonia was relatively stable and related to depressive symptoms (both between and within person). Physical anhedonia was also related to certain aspects of functioning, though less robustly than depressive symptoms. Because depressive symptoms, functioning, and physical anhedonia were measured concurrently at each follow-up, the direction of causality among these variables could not be assessed. Additionally, because our sample was recruited from inpatient settings, our findings may not generalize to individuals with less severe depression. A trait tendency to experience decreased pleasure to positive physical stimuli is a clinically meaningful variable for those with MDD and may be a behavioral endophenotype for a more severe form of depression.
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