Anhedonia and substance dependence: clinical correlates and treatment options.
Anhedonia and substance dependence: clinical correlates and treatment options.
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DOI：
10.3389/fpsyt.2011.00010
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发表时间：
2011
影响因子：
4.7
通讯作者：
Janiri L
中科院分区：
文献类型：
--
作者：
Hatzigiakoumis DS;Martinotti G;Giannantonio MD;Janiri L
快感缺乏症是一种完全或部分丧失体验快乐能力的状态，它既指各种精神疾病的状态症状，也指一种人格特征。它有一个假定的神经底物，起源于多巴胺能中脑边缘和中脑皮层奖赏回路。快感缺乏经常发生在心境障碍中，作为精神分裂症和物质使用障碍的阴性症状。特别是，我们将注意力集中在快感缺乏和物质使用障碍之间发生的关系上，正如许多研究所强调的那样。一些作者认为，快感缺乏是一个重要的因素，涉及复发，以及从娱乐性使用过渡到过量的药物摄入。特别是，在急性和慢性戒断期间，以及在可卡因、兴奋剂和大麻滥用者中，发现快感缺乏是酗酒者和成瘾患者的常见特征。此外，在有物质依赖障碍的受试者中，快感缺乏、渴望、戒断症状的强度与社会心理和人格特征之间存在显著的相关性。因此，考虑到快感缺乏症与渴望的密切关系，治疗酒精依赖解毒者的快感缺乏症在预防复发策略方面可能是至关重要的。
Anhedonia is a condition in which the capacity of experiencing pleasure is totally or partially lost, and it refers to both a state symptom in various psychiatric disorders and a personality trait. It has a putative neural substrate, originating in the dopaminergic mesolimbic and mesocortical reward circuit. Anhedonia frequently occurs in mood disorders, as a negative symptom in schizophrenia, and in substance use disorders. In particular, we focus our attention on the relationships occurring between anhedonia and substance use disorders, as highlighted by many studies. Several authors suggested that anhedonia is an important factor involved in relapse as well as in the transition from recreational use to excessive drug intake. In particular, anhedonia has been found to be a frequent feature in alcoholics and addicted patients during acute and chronic withdrawal as well as in cocaine, stimulant, and cannabis abusers. Furthermore, in subjects with a substance dependence disorder, there is a significant correlation between anhedonia, craving, intensity of withdrawal symptoms, and psychosocial and personality characteristics. Therefore treating anhedonia in detoxified alcohol-dependent subjects could be critical in terms of relapse prevention strategies, given its strong relationship with craving.