Abstract
Anhedonia can be defined as a condition in which the hedonic capacity is totally or partially lost. From a psychobiological perspective, several researchers proposed that anhedonia has a putative neural substrate, the dopaminergic mesolimbic and mesocortical reward circuit, which involves the ventral tegmental area, the ventral striatum and part of the prefrontal cortex. Anhedonia is, besides depressed mood, one of the two core symptoms of depression; furthermore it is one of the most important negative symptom in schizophrenia. Anhedonia is also present in substance use disorders as part of the abstinence symptomatology, and interrelations between hedonic capability, craving and protracted withdrawal have been found, particularly in opiate-dependent subjects. Although anhedonia is regarded as an important symptom in psychopathology, so far it has received relatively little attention. In general, two main approaches have been utilized to investigate and assess anhedonia or hedonic capacity: laboratory-based measures and questionnaires. Among measurement scales, the most commonly used are the Snaith-Hamilton Pleasure Scale (SHAPS), the Fawcett-Clark Pleasure Scale (FCPS), and the Revised Chapman Physical Anhedonia Scale (CPAS). Nevertheless, other measurement scales, particularly used within broader psychopathological dimensions, are the Anhedonia-Asociality subscale (SANSanh) of the Scale for the Assessment of Negative Symptoms (SANS) and the Bech-Rafaelsen Melancholia Scale (BRMS). In this paper we analyze these different scales, individuating their strengths and limits and their current clinical applications.
Highlights
The word anhedonia comes from ancient Greek: ἀν- an, “without” + ἡδονή hēdonē, “pleasure”, and it was introduced in Psychiatry by Théodule-Armand Ribot in 1896 [1]
These data were confirmed and enriched by following studies made by Martinotti et al [31], who found that the positive correlation between the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) score and anhedonia scales was consistent with the hypothesis that the clinical dimension of anhedonia cannot be separated from the other behavioural symptoms of withdrawal and should be considered as part of the same process
The possibility that difficulty in experiencing pleasure in psychiatric disorders can lead to the use of psychoactive substances in an attempt to decrease anhedonia, is extended to subjects without psychiatric disorders, who may try substances to counterbalance a tonic state of anhedonia
Summary
The word anhedonia comes from ancient Greek: ἀν- an-, “without” + ἡδονή hēdonē, “pleasure”, and it was introduced in Psychiatry by Théodule-Armand Ribot in 1896 [1]. Interesting findings about the presence and correlation of anhedonia in substance related disorders have been found by Janiri et al [30], who found interrelations between hedonic capability, craving and protracted withdrawal, in opiate-dependent subjects, in a study published in 2005, in which were enrolled 70 alcohol-, opiate- or multiple substance-dependent subjects. Kraepelin [51] described anhedonia as a state of individual suffering which was part of the dementia praecox Kraepelin described his patients as if they could not feel any real joy in life; according to him, the characteristic indifference of patients towards social interactions, the extinction of affection for family and friends and the loss of satisfaction in their works and occupations, in recreation and pleasure, was rather often the first symptom to manifest, marking the onset of the disease. A study by Hasler et al [62], published in 2004 demonstrated that anhedonia, together with increased stress reactivity, is the most important candidate for psychopathological endophenotype of major depression
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
