Snaith-Hamilton Pleasure Scale Scores Research Articles

Determining cut-off values and predictors for the Snaith-Hamilton Pleasure Scale: comparison between clinical and school settings.

Few previous studies have established Snaith-Hamilton Pleasure Scale (SHAPS) cut-off values using receiver operating characteristic curve analysis and applied these values to compare predictors of anhedonia between clinical and nonclinical groups. To determine the optimal cut-off values for the SHAPS and use them to identify predictors of anhedonia in clinical and nonclinical groups in Taiwan. This cross-sectional and correlational study used convenience sampling to recruit 160 patients from three hospitals and 412 students from two universities in northern Taiwan. Data analysis included receiver operating characteristic curve, univariate and multivariate analyses. The optimal SHAPS cut-off values were 29.5 and 23.5 for the clinical and nonclinical groups, respectively. Moreover, two-stage analysis revealed that participants in the clinical group who perceived themselves as nondepressed, and participants in the nonclinical group who did not skip classes and whose fathers exhibited higher levels of care and protection were less likely to attain the cut-off values. Conversely, participants in the nonclinical group who reported lower academic satisfaction and were unwilling to seek help from family or friends were more likely to attain the cut-off values. Our findings highlight the importance of optimal cut-off values in screening for depression risk within clinical and nonclinical groups. Accordingly, the development of comprehensive, individualised programmes to monitor variation trends in SHAPS scores and relevant predictors of anhedonia across different target populations is crucial.

Trajectories of anhedonia symptoms after traumatic injury

Anhedonia describes the inability or difficulty of experiencing or seeking pleasure. Previous research has demonstrated a relationship between posttraumatic stress disorder (PTSD) or experiencing trauma and anhedonia symptoms; however, little to no work has been done to understand the evolution of anhedonia symptoms after trauma. We aimed to identify anhedonia trajectories following traumatic injury. One hundred ninety-five participants were recruited from the emergency department of a Level-1 Trauma Center after experiencing a traumatic injury. To measure anhedonia symptoms, participants completed the Snaith-Hamilton Pleasure Scale (SHAPS) at 2-weeks, 3-months, and 6-months post-injury. Using latent class mixture modeling, we ran a trajectory analysis with three timepoints of SHAPS scores and compared mental and physical health outcomes across trajectories. Most of the sample fell in the resilient trajectory (85 %), while the remainder were in a remitting trajectory (7 %) where symptoms decreased over time, and a delayed (6 %) trajectory where symptoms did not emerge until 3-months after injury. In the resilient trajectory, there was consistently low levels of PTSD, pain, depression, and anxiety relative to the other trajectories. In the delayed trajectory, depression and PTSD were chronically elevated and pain levels were consistent but mild. In the remitting trajectory, PTSD and depression symptoms decreased over time. Identified anhedonia trajectories mirrored trajectories commonly reported for PTSD symptoms after injury. Evaluating anhedonia trajectories and how they relate to mental health outcomes may inform targeted interventions for traumatic injury patients.

Personality characteristics, not clinical symptoms, are associated with anhedonia in a community sample: A preliminary investigation

Anhedonia is a salient transdiagnostic psychiatric symptom associated with increased illness severity and chronicity. Anhedonia is also present to varying degrees in non-clinical cohorts. Here, we sought to examine factors influencing expression of anhedonia. Participants (N = 335) were recruited through the Nathan Kline Institute-Rockland Sample, an initiative to deeply phenotype a large community sample across the lifespan. Utilizing a data-driven approach, we evaluated associations between anhedonia severity, indexed by Snaith-Hamilton Pleasure Scale (SHAPS), and 20 physical, developmental, and clinical measures, including Structured Clinical Interview for DSM-IV, Beck Depression Inventory, State-Trait Anxiety Inventory, NEO Five-Factor Inventory-3 (NEO–FFI–3), BMI, Hemoglobin A1C, and demography. Using a bootstrapped AIC-based backward selection algorithm, seven variables were retained in the final model: NEO–FFI–3 agreeableness, extraversion, and openness to experience; BMI; sex; ethnicity; and race. Though median SHAPS scores were greater in participants with psychiatric diagnoses (18.5) than those without (17.0) (U = 12238.5, z = 2.473, p = 0.013), diagnosis and symptom measures were not retained as significant predictors in the final robust linear model. Participants scoring higher on agreeableness, extraversion, and openness to experience reported significantly lower anhedonia. These results demonstrate personality as a mild-to-moderate but significant driver of differences in experiencing pleasure in a community sample.

Altered neural activity in the reward-related circuit associated with anhedonia in mild to moderate Major Depressive Disorder

BackgroundAnhedonia is a significant predictor of disease progression and treatment outcomes in Major Depressive Disorder (MDD), linked to reward network dysfunctions. However, understanding of its underlying neural mechanisms remains limited. This study aimed to investigate the brain functional mechanisms underlying MDD with anhedonia using resting-state functional magnetic resonance imaging (rs-fMRI). MethodsThe Snaith-Hamilton Pleasure Scale (SHAPS) was used to evaluation MDD with anhedonia (anMDD) and non-anhedonia MDD (non-anMDD). Forty-eight patients with anMDD, Forty-four patients with non-anMDD, and Fifty healthy controls (HCs) were enrolled for the fMRI scans. A seed-based functional connectivity (FC) method was employed to explore reward network abnormalities. ResultsanMDD patients exhibited lower FC values in Ventral Striatum (VS), right lateral Ventral Tegmental Area (VTA_R), left Thalamus (THA_L), and higher FC values in Ventromedial Prefrontal Cortex (vmPFC), left Anterior Insula (AI_L), and Presupplementary Motor Area (Pre-SMA) compared to HCs. Comparing anMDD to non-anMDD, significant differences were observed in FC values of VS, vmPFC, Pre-SMA, and THA_L regions. Correlation analysis revealed positive correlations between FC values of VS_R and NAc_R, as well as THA_L and Cerebellum_Crus1_L, with SHAPS scores. Negative correlations were observed between FC values of Pre-SMA and the right caudate, and between vmPFC and Frontal_Mid_Orb_L, and SHAPS scores. ConclusionBoth anMDD and non-anMDD groups demonstrated abnormal FCs in the reward network. These findings indicate distinct roles of reward-related circuits in the two subtypes, contributing to a refined understanding of depression phenotypes and potential directions for targeted interventions.

Changes of Serum C-Reactive Protein Level in Patients With Depressive Disorders After Treatment With Agomelatine Combined With Aerobic Exercise and Its Significance.

Depressive disorders constitute a series of debilitating diseases. This study investigated the therapeutic effect of agomelatine (AG) combined with aerobic exercise (AE) on patients with moderate-severe depression (MSD) and the changes of the serum C-reactive protein (CRP) level in patients after treatment as well as its significance. A total of 178 MSD patients were randomly assigned to the AG group (N = 90) and AG + AE group (N = 88). The severity of depressive disorders and anhedonia was assessed using the Hamilton Rating Scale for Depression (HAM-D), Beck Depression Inventory, and Snaith-Hamilton Pleasure Scale scores. The serum CRP level in MSD patients was detected by turbidity assay. Patients were defined as remitters, responders, and nonresponders according to the HAM-D17 score, and the treatment efficacy was analyzed, followed by evaluation of the serum CRP level in patients with different treatment responses. Finally, the adverse reactions of patients during treatment were statistically analyzed. After treatment, the HAM-D, Beck Depression Inventory, and Snaith-Hamilton Pleasure Scale scores and the serum CRP level of the 2 groups were reduced, and changes in the AG + AE group was more significant than that in the AG group. The clinical efficacy of the AG + AE group was better than that of the AG group. After treatment, the serum levels of CRP in remitters and responders were reduced, but not significantly in nonresponders. The incidence of adverse events in the AG + AE group was lower than that in the AG group. AG + AE reduced the serum level of CRP in MSD patients and had good therapeutic effects on MSD patients.

Parsing within & between-person dynamics of therapy homework completion and clinical symptoms in two cognitive behavioral treatments for adults with anhedonia

ObjectiveHomework is a key theoretical component of cognitive-behavioral therapies, however, the effects of homework on clinical outcomes have largely been evaluated between-persons rather than within-persons. MethodsThe effects of homework completion on treatment response were examined in a randomized trial comparing Behavioral Activation Treatment for Anhedonia (BATA, n = 38), a novel psychotherapy, to Mindfulness-Based Cognitive Therapy (MBCT, n=35). The primary endpoint was consummatory reward sensitivity, measured weekly by the Snaith Hamilton Pleasure Scale (SHAPS), up to 15 weeks. Multilevel models evaluated change in SHAPS scores over time and the effects of clinician-reported and participant-reported homework. ResultsBATA and MBCT resulted in significant, equivalent reductions in SHAPS scores. Unexpectedly, participants who completed greater mean total amounts of homework did not improve at a faster rate (i.e., no between-person effect). However, sessions with greater than average participant-reported homework completion were associated with greater than average reductions in SHAPS scores (i.e., a within-person effect). For clinician-reported homework, this effect was only evident within the BATA condition. ConclusionThis study shows psychotherapy homework completion relates to symptomatic improvement in cognitive-behavioral treatments for anhedonia when session-to-session changes are examined within-person. On the contrary, we found no evidence that total homework completion predicted greater improvements between-person. When possible, psychotherapy researchers should evaluate their constructs of interest across multiple sessions (not just pre/post) to allow more direct tests of hypotheses predicted by theoretical models of individual change processes.

Anhedonia and dysregulation of an angular gyrus-centred and dynamic functional network in adolescent-onset depression

BackgroundAnhedonia is an important aspect of adolescent-onset major depressive disorder (MDD) and is associated with increased risk of suicidal behaviors and poor treatment outcomes. However, the neural circuitry underlying this deficit has not been well defined. This study aims to identify the relationships between anhedonia and changes in static and dynamic functional connectivity (FC) in adolescent-onset MDD patients compared with healthy control subjects (HCs) and adult-onset MDD patients. MethodsA total of 157 participants completed the Snaith-Hamilton Pleasure Scale (SHAPS) to assess hedonic capacity. Resting-state functional imaging scans were analysed using graph theoretical analysis, network-based statistics (NBS) and sliding window correlation analysis to explore the potential patterns of neural network brain disruptions in adolescent-onset MDD. Pearson correlations and support vector machines regression (SVR) were used to explore correlations and predict network measures with SHAPS scores. ResultsCompared with those with adult-onset MDD, adolescent-onset MDD patients showed decreased FC in 7 nodes and 6 connections, with the right angular gyrus (AG), left AG and left paracentral lobule having the largest number of connected edges (P = 0.0396, NBS-corrected). Their average FC and SHAPS scores were positively correlated (r = 0.309, P = 0.035). Regarding dynamic FC, compared with HCs, adolescent-onset MDD patients showed a tendency towards a decreased frequency in moderate-intensity brain FC states (P = 0.014), which was significantly and positively correlated with SHAPS scores (r = 0.425, P = 0.003). SVR also revealed AG-centred FC and dynamic FC could predict SHAPS scores (MSE = 27.233, P = 0.001). ConclusionsThese findings provide distinct evidence on the physiological mechanisms of adolescent-onset MDD and anhedonia.

Study on the Changes in Circadian Rhythm Before and After Treatment and the Influencing Factors in Patients with Depression.

To investigate the circadian rhythms of patients with major depressive disorder (MDD) pre-treatment and post-treatment to analyse possible influencing factors. In this study, we recruited 154 patients in the acute phase of MDD from 10 psychiatric centers in the province. The patients were divided into a morning chronotype group (16-41 points), an intermediate chronotype group (42-58 points) and an evening chronotype group (59-86 points), according to the total scores obtained from the morningness-eveningness questionnaire (MEQ). They were treated randomly with antidepressants, either selective serotonin reuptake inhibitors or agomelatine, for 12 weeks and were evaluated using the MEQ, the 17-item Hamilton Depression Rating Scale (HAMD-17), the Hamilton anxiety scale, the Snaith-Hamilton pleasure scale (SHAPS), the multidimensional fatigue inventory (MFI-20) and the Pittsburgh sleep quality index at the baseline and then at 2, 4, 8 and 12 weeks. The results were analysed by Logistic regression analysis and repeated-measures analysis of variance. The baseline detection rates for the evening, intermediate and morning types were 14.93%, 56.5% and 28.57%, respectively. HAMD-17 scores were significantly lower at weeks 2, 4, 8, and 12 after treatment in patients with different concurrent phenotypes compared with those before treatment (P<0.05). There were significant differences in gender, age, body mass index, whether depression was first-episode, type of medication, baseline-MEQ and baseline-SHAPS in the chronotype change group compared with the post-treatment chronotype unchanged group (p<0.05). Logistic regression analysis showed that medication type (P=0.047), baseline MEQ (P=0.001) and baseline SHAPS (P=0.001) were risk factors for improvement in circadian rhythm after treatment for depression. Circadian rhythm disturbances can be adjusted to a normal pattern with effective antidepressant therapy. The medication type, baseline MEQ and baseline SHAPS scores were the influencing factors for the recovery of circadian rhythm disorders.

Change of Circulating Vascular Endothelial Growth Factor Level and Reduction of Anhedonia Are Associated in Patients With Major Depressive Disorder Treated With Repetitive Transcranial Magnetic Stimulation

AimVascular endothelial growth factor (VEGF) has been implicated in mediating the effect of antidepressant therapies as it plays a significant role in the neurogenesis. Anhedonia, an endophenotype of major depressive disorder (MDD), is related to the dorsolateral prefrontal cortex, the major focus of brain stimulation in MDD. The aim of our study was to analyze the change of serum VEGF level after rTMS treatment in association with anhedonia.Materials and MethodsA dataset of 17 patients with TRD who were treated with antidepressants and bilateral rTMS for 2 × 5 days was analyzed. Depression was measured by the Montgomery–Asberg Depression Scale (MADRS) and anhedonia by the Snaith–Hamilton Pleasure Scale (SHAPS) for monitoring the symptom changes. The serum VEGF levels and symptoms were assessed on the first (V1), on the 14th (V2), and on the 28th day (V3). The level of VEGF was measured by ELISA assay.ResultsThere was no significant association between MADRS scores and serum VEGF levels at any timepoint. The decrease in the SHAPS score was significantly associated with the increase in VEGF level between V1 and V2 (p = 0.001). The VEGF levels were significantly higher in non-responders than in responders (p = 0.04). The baseline VEGF level has been proven as a significant predictor of treatment response (p = 0.045).ConclusionOur results suggest that serum VEGF can be sensitive to the changes of anhedonia during rTMS treatment. Considering that the most widely used depression scales are not applicable for the assessment of anhedonia, measurement of anhedonia in rTMS treatment studies of patients with TRD can be suggested as more appropriate data on distinct pathogenic pathways and specific biomarkers of the disorder.

Preliminary Evidence of Efficacy and Target Engagement of Pramipexole in Anhedonic Depression.

ObjectiveTo investigate feasibility and target engagement of high‐dose, add‐on pramipexole treatment in anhedonic depression.MethodIn this open‐label pilot study, we included 12 patients with unipolar or bipolar, moderate‐to‐severe depression and with significant anhedonia symptoms. All patients were on a stable dose of one or a combination of antidepressants and/or mood stabilizers and received 10 weeks of adjunctive pramipexole titrated to a maximum dose of 4.5 mg salt/day. All patients were rated with the Dimensional Anhedonia Rating Scale (DARS), the Montgomery Åsberg Depression Rating (MADRS) and the Snaith Hamilton Pleasure Scale (SHAPS). Serum high‐sensitivity C‐reactive protein (hs‐CRP) was analyzed pre‐ and post‐treatment. Eight patients underwent fMRI pre‐ and post‐treatment and a simplified version of the monetary incentive delay task was used to investigate the effect of treatment on striatal activity during reward anticipation.ResultsDARS, MADRS and SHAPS scores all improved significantly over 10 weeks of pramipexole treatment (p<0.01). Mean levels of hs‐CRP decreased significantly over the course of treatment from mean 3.8 mg/L at baseline to 2.6 mg/L at endpoint (p<0.01). There were significant treatment‐associated increases in reward related activity in several brain areas including the right lateral putamen, anterior left caudate, left posterior putamen, right dorsal caudate, left anterior putamen, and the right nucleus accumbens.ConclusionsThis is the first study to suggest efficacy and target engagement of pramipexole in anhedonic depression. Larger randomized controlled trials are needed to confirm or refute these preliminary findings.

High efficiency of left superior frontal gyrus and the symptom features of major depressive disorder.

Major depressive disorder (MDD) patients with anhedonia tend to have a poor prognosis. The underlying imaging basis for anhedonia in MDD remains largely unknown. The relationship between nodal properties and anhedonia in MDD patients need to be further investigated. Herein, this study aims to explore differences of cerebral functional node characteristics in MDD patients with severe anhedonia (MDD-SA) and MDD patients with mild anhedonia (MDD-MA) before and after the antidepressant treatment. Ninety participants with current MDD were recruited in this study. 24-Item Hamilton Depression Scale (HAMD-24) and Snaith-Hamilton Pleasure Scale (SHAPS) were used to assess the severity of depression and anhedonia at baseline and the end of 6-months treatment. The MDD patients who scored above the 25th percentile on the SHAPS were assigned to an MDD-SA group (n=19), while those who scored below the 25th percentile were assigned to an MDD-MA group (n=18). All patients in the 2 groups received antidepressant treatment. Functional magnetic resonance imaging (fMRI) images of all the patients were collected at baseline and the end of 6-months treatment. Graph theory was applied to analyze the patients' cerebral functional nodal characteristics, which were measured by efficiency (ei) and degree (ki). Repeated measures 2-factor ANCOVA showed significant main effects on group on the ei and ki values of left superior frontal gyrus (LSFG) (P=0.003 and P=0.008, respectively), and on the ei and ki values of left medial orbital-frontal gyrus (LMOFG) (P=0.004 and P=0.008, respectively). Compared with the MDD-MA group, the significantly higher ei and ki values of the LSFG (P=0.015 and P=0.021, respectively), and the significantly higher ei and ki values of the LMOFG (P=0.015 and P=0.037, respectively) were observed in the MDD-SA group at baseline. Meanwhile, higher SHAPS scores could result in higher ei and ki values of LSFG (P=0.019 and P=0.026, respectively), and higher ei value of LMOFG (P=0.040) at baseline; higher SHAPS scores could result in higher ei values of LSFG (P=0.049) at the end of 6-months treatment. The multiple linear regression analysis revealed that sex were negatively correlated with the ei and ki values of LSFG (r= -0.014, P=0.004; r=-1.153, P=0.001, respectively). The onset age of MDD was negatively correlated with the ki value of LSFG (r=-0.420, P=0.034) at the end of 6-months treatment. We also found that SHAPS scores at baseline were positively correlated with the HAMD-24 scores (r=0.387, P=0.022) at the end of 6-months treatment. There are obvious differences in nodal properties between the MDD-SA and the MDD-MA patients, such as the high ei of LSFG in the MDD-SA patients, which may be associated with the severity of anhedonia. These nodal properties could be potential biomarkers for the prognosis of MDD. The increased ei and ki values in the LSFG of MDD-SA patients may underlie a compensatory mechanism or protective mechanism. The mechanism may be an important component of the pathological mechanism of MDD-SA. The poor prognosis in the MDD-SA patients suggests that anhedonia may predict a worse prognosis in MDD patients. Sex and onset age of MDD may affect the nodal properties of LSFG at baseline and the end of 6-months treatment.

Anhedonia difference between major depressive disorder and bipolar disorder II

ObjectiveThis study aims to explore the difference in anhedonia between Major Depressive Disorder (MDD) and Bipolar Disorder II (BD-II), and attempt to distinguish the two diseases through Snaith-Hamilton Pleasure Scale (SHAPS).MethodsA total of 164 drug-free depressive patients (98 MDD patients, 66 BD-II patients) completed the investigation. 17-item Hamilton Depression Scale (HAMD-17) and Hamilton Anxiety Scale (HAMA) and SHAPS were assessed in all participants.ResultsOur results showed that BD-II patients had higher SHAPS scores than MDD patients. The stepwise logistic regression analysis further revealed that SHAPS score, drinking habit, and extroversion as influencing factors for the identification of BD-II. The ROC curve analysis indicated that SHAPS could differentiate BD-II from MDD patients (AUC = 0.655, P = 0.001, 95% CI = 0.568 to 0.742), with the best screening cutoff at 26, and the corresponding sensitivity and specificity was 0.788 and 0.520, respectively.ConclusionOur results suggest that BD-II patients had more severe anhedonia compared to MDD patients, and the difference in anhedonia may help clinicians preliminary identify BD patients from MDD patients. The preliminary findings are worthly of further exploration.

Apathy and Anhedonia in Adult and Adolescent Cannabis Users and Controls Before and During the COVID-19 Pandemic Lockdown.

BackgroundCOVID-19 lockdown measures have caused severe disruptions to work and education and prevented people from engaging in many rewarding activities. Cannabis users may be especially vulnerable, having been previously shown to have higher levels of apathy and anhedonia than non-users.MethodsIn this survey study, we measured apathy and anhedonia, before and after lockdown measures were implemented, in n = 256 adult and n = 200 adolescent cannabis users and n = 170 adult and n = 172 adolescent controls. Scores on the Apathy Evaluation Scale (AES) and Snaith-Hamilton Pleasure Scale (SHAPS) were investigated with mixed-measures ANCOVA, with factors user group, age group, and time, controlling for depression, anxiety, and other drug use.ResultsAdolescent cannabis users had significantly higher SHAPS scores before lockdown, indicative of greater anhedonia, compared with adolescent controls (P = .03, η p2 = .013). Contrastingly, adult users had significantly lower scores on both the SHAPS (P < .001, η p2 = .030) and AES (P < .001, η p2 = .048) after lockdown compared with adult controls. Scores on both scales increased during lockdown across groups, and this increase was significantly smaller for cannabis users (AES: P = .001, η p2 = .014; SHAPS: P = .01, η p2 = .008). Exploratory analyses revealed that dependent cannabis users had significantly higher scores overall (AES: P < .001, η p2 = .037; SHAPS: P < .001, η p2 = .029) and a larger increase in scores (AES: P = .04, η p2 =.010; SHAPS: P = .04, η p2 = .010), compared with non-dependent users.ConclusionsOur results suggest that adolescents and adults have differential associations between cannabis use as well as apathy and anhedonia. Within users, dependence may be associated with higher levels of apathy and anhedonia regardless of age and a greater increase in levels during the COVID-19 lockdown.

Symptom improvement is associated with serum cytokine level change during RTMS tretament in patients with treatment resistant depression

IntroductionIntroduciton: Repetetive transcranial magnetic stimulation (rTMS) is an effective and safety noninvasive technique for treatment of major depression disorder (MDD). There is a body of increasing evidences on the potential molecular mechanisms underlying its effectivity even in case of treatment resistant depression (TRD), however, the exact mechanism is still not clarified. Among multiple biological systems, inflammation can be a target of rTMS in MDD (Tian et al. 2020; Tateishi et al. 2020).ObjectivesHere we analysed serum cytokine levels in TRD before and after rTMS interventions.MethodsWe used bilateral stimulation (15Hz for left DLPC and 1Hz on the right side) in 18 patients with TRD (5 men and 13 women; mean age=47.7±12.1 year) for 2x5 days. Blood samples were collected before the first (V1) and after the last inetrevntion (V2). Phenotypic changes were measured by Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Snaith–Hamilton Pleasure Scale (SHAPS), Insomnia Severity Index (ISI) and Stroop Color-Word Test (SCWT) modified by Golden. Inflammatory cytokines were assessed by ELISA assays.ResultsChange of BDI and BAI scores between V1 and V2 is associated with difference of TNFalpha levels (p=0.043; adj.R2=0.42 p=0.011; adj R2=0.43). Decrease on SHAPS score has been depended on IL-6 level (p=0.027) and the interaction of TNFalpha and IL-10 (p=0.005; adj R2=0.63). Sleep disturbance and neurocognitive function was not associated with cytokine levels.ConclusionsOur results confirmed the association between depressive, anxious and anhedonia symptom improvement and inflammatory mechansims during rTMS treatment. The study was supported by the OTKA 151513 grant.

Impact of the KCNQ2/3 Channel Opener Ezogabine on Reward Circuit Activity and Clinical Symptoms in Depression: Results From a Randomized Controlled Trial.

Preclinical studies point to the KCNQ2/3 potassium channel as a novel target for the treatment of depression and anhedonia, a reduced ability to experience pleasure. The authors conducted the first randomized placebo-controlled trial testing the effect of the KCNQ2/3 positive modulator ezogabine on reward circuit activity and clinical outcomes in patients with depression. Depressed individuals (N=45) with elevated levels of anhedonia were assigned to a 5-week treatment period with ezogabine (900 mg/day; N=21) or placebo (N=24). Participants underwent functional MRI during a reward flanker task at baseline and following treatment. Clinical measures of depression and anhedonia were collected at weekly visits. The primary endpoint was the change from baseline to week 5 in ventral striatum activation during reward anticipation. Secondary endpoints included depression and anhedonia severity as measured using the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Snaith-Hamilton Pleasure Scale (SHAPS), respectively. The study did not meet its primary neuroimaging endpoint. Participants in the ezogabine group showed a numerical increase in ventral striatum response to reward anticipation following treatment compared with participants in the placebo group from baseline to week 5. Compared with placebo, ezogabine was associated with a significantly larger improvement in MADRS and SHAPS scores and other clinical endpoints. Ezogabine was well tolerated, and no serious adverse events occurred. The study did not meet its primary neuroimaging endpoint, although the effect of treatment was significant on several secondary clinical endpoints. In aggregate, the findings may suggest that future studies of the KCNQ2/3 channel as a novel treatment target for depression and anhedonia are warranted.

Anhedonia in Major Depressive Disorder: Can it be the Chicken AND the Egg for Transcranial Magnetic Stimulation?

Background: Anhedonia is a severely debilitating hallmark feature of Major Depressive Disorder (MDD) and a symptom which is often difficult to treat. Little is known regarding the relationship between anhedonia and transcranial magnetic stimulation (TMS). Improvement in anhedonia after TMS and its potential utility as a predictor of clinical outcome were studied. Methods: Snaith-Hamilton Pleasure Scale (SHAPS), a validated 14-question self-assessment for anhedonia, was collected in a naturalistic setting before and after TMS for treatment resistant MDD. Inventory of Depressive Symptomatology Self Report (IDS-SR) was used as a measure of clinical response and remission of MDD. For each session, stimulation at 120% of motor threshold was administered over the left dorsolateral prefrontal cortex at 10 Hz for 3000-4000 pulses/session. Results: Data from 116 clinic patients receiving TMS for the first time who completed SHAPS from July 2016 to October 2019 were analyzed. 72.4% (n=84) of the patients met criteria for severe anhedonia (defined as SHAPS score>5) prior to TMS. The group showed significant improvement in hedonic drive from baseline to post-treatment on SHAPS overall (7.95±3.78 vs 3.11±3.64, p<.00001). The % change in SHAPS was significantly greater in responders vs non-responders (68.8%±27.6 vs 20.8±24.4, p<.00001). However, TMS non-responders, responders, and remitters did not differ on baseline mean SHAPS, and logistic regression showed baseline anhedonia severity was not a significant predictor of clinical outcome. Conclusion: Greater anhedonia among MDD patients in this study did not predict different outcomes for TMS. However, TMS is an efficacious intervention for anhedonic symptoms.

Assessment of Anhedonia in Adults With and Without Mental Illness

ImportanceAnhedonia, a reduced capacity for pleasure, is described for many psychiatric and neurologic conditions. However, a decade after the Research Domain Criteria launch, whether anhedonia severity differs between diagnoses is still unclear. Reference values for hedonic capacity in healthy humans are also needed.ObjectiveTo generate and compare reference values for anhedonia levels in adults with and without mental illness.Data SourcesWeb of Science, Scopus, PubMed, and Google Scholar were used to list all articles from January 1, 1995 to July 2, 2019, citing the scale development report of a widely used anhedonia questionnaire, the Snaith-Hamilton Pleasure Scale (SHAPS). Searches were conducted from April 5 to 11, 2018, and on July 2, 2019.Study SelectionStudies including healthy patients and those with a verified diagnosis, assessed at baseline or in a no-treatment condition with the complete 14-item SHAPS, were included in this preregistered meta-analysis.Data Extraction and SynthesisRandom-effects models were used to calculate mean SHAPS scores and 95% CIs separately for healthy participants and patients with current major depressive disorder (MDD), past/remitted MDD, bipolar disorder, schizophrenia, substance use disorders, Parkinson disease, and chronic pain. SHAPS scores were compared between groups using meta-regression, and traditional effect size meta-analyses were conducted to estimate differences in SHAPS scores between healthy and patient samples. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines.Main Outcomes and MeasuresSelf-reported anhedonia as measured by 2 different formats of the SHAPS (possible ranges, 0-14 and 14-56 points), with higher values on both scales indicating greater anhedonia symptoms.ResultsIn the available literature (168 articles; 16 494 participants; 8058 [49%] female participants; aged 13-72 years), patients with current MDD, schizophrenia, substance use disorder, Parkinson disease, and chronic pain scored higher on the SHAPS than healthy participants. Within the patient groups, those with current MDD scored considerably higher than all other groups. Patients with remitted MDD scored within the healthy range (g = 0.1). This pattern replicated across SHAPS scoring methods and was consistent across point estimate and effect size analyses.Conclusions and RelevanceThe findings of this meta-analysis indicate that the severity of anhedonia may differ across disorders associated with anhedonia. Whereas anhedonia in MDD affects multiple pleasure domains, patients with other conditions may experience decreased enjoyment of only a minority of life’s many rewards. These findings have implications for psychiatric taxonomy development, where dimensional approaches are gaining attention. Moreover, the SHAPS reference values presented herein may be useful for researchers and clinicians assessing the efficacy of anhedonia treatments.

Anhedonia and functional dyspepsia in obese patients: Relationship with binge eating behaviour.

BACKGROUNDObese patients (Ob) with a binge eating disorders (BED) behavior pattern have a higher prevalence of postprandial distress syndrome (PDS) compared to Ob without a BED behavior pattern, while an increase of PDS has been described in Ob after sleeve gastrectomy (SG). Hedonic response to a meal is dissociable from satiation in healthy subjects. Anhedonia is the lowered ability to experience pleasure. There are no studies investigating the presence of anhedonia in Ob with and without SG and its relationship to PDS symptoms.AIMTo assess the relationship among anhedonia, BED and upper gastrointestinal symptoms in two group of morbidly Ob with and without SG.METHODSEighty-one Ob without SG, 45 Ob with SG and 55 healthy controls (HC) were studied. All subjects fulfilled the binge eating scale (BES) to investigate BED, the validated 14 items Snaith-Hamilton pleasure scale (SHAPS) to assess Anhedonia as well as the Beck Depression Inventory-II (BDI II) and State Trait Anxiety Inventory (STAI) questionnaires to screen for depression and anxiety. All patients underwent a standardized questionnaire investigating the intensity-frequency scores (0-6) of upper gastrointestinal symptoms and were diagnosed for the presence of functional dyspepsia (FD) and its subtypes according to ROME IV criteria.RESULTSOb without SG who were positive for BED had a 4.7 higher risk of FD compared to Ob without SG who were negative for BED (OR: 4.7; 95.0%CI 1.23-18.24; P = 0.02). STAI-Y2 scores were significantly higher in Ob without SG positive for BED (42.2 ± 1.5 vs Ob negative for BED: 39.6 ± 1 .0, P = 0.04), while SHAPS scores and BDI II did not differ in the two groups (1.16 ± 1.30 vs 0.89 ± 1.02, P = 0.49). A lower prevalence of BED (BES > 17: 11.4% vs 40.7%, P = 0.001) and BDI-II (6.8 ± 1.2 vs 13.8 ± 1.9, P = 0.005) was reported in Ob with SG than Ob without SG, on the contrary total mean scores of STAI-Y1 and STAI-Y2 were significantly higher in Ob with SG than Ob without SG. Thirty-five percent of Ob with SG fulfilled the diagnosis of FD. SHAPS mean scores and the prevalence of anhedonia did not differ among the two groups (18.2 vs 8.1%, P = 0.2). Fifty-four percent of Ob with SG achieved surgical success excess weight loss > 50%. Excess weight loss was negatively related to SHAPS total mean scores [adjusted B: -7. 099 (95%CI: -13.91 to -0.29), P = 0.04].CONCLUSIONOb without SG showed a higher prevalence of PDS, mood disorders and anxiety when positive for BE behavior compared to those negative for BE behavior, whereas no differences were found in SHAPS score. Ob with SG showed a higher prevalence of PDS compared to Ob without SG. Concerning psychological aspect, BED and depression are less frequent in the Ob with SG, while both state and trait anxiety are significantly higher. Moreover, the more an Ob with SG is anhedonic, less surgical success was achieved.

Association between GLP-1 receptor gene polymorphisms with reward learning, anhedonia and depression diagnosis.

Glucagon-like peptide-1 receptors (GLP-1Rs) are widely expressed in the brain. Evidence suggests that they may play a role in reward responses and neuroprotection. However, the association of GLP-1R with anhedonia and depression diagnosis has not been studied. Here, we examined the association of GLP-1R polymorphisms with objective and subjective measures of anhedonia, as well as depression diagnosis. Objective [response bias assessed by the probabilistic reward task (PRT)] and subjective [Snaith-Hamilton Pleasure Scale (SHAPS)] measures of anhedonia, clinical variables and DNA samples were collected from 100 controls and 164 patients at McLean Hospital. An independent sample genotyped as part of the Psychiatric Genomics Consortium (PGC) was used to study the effect of putative GLP-1R polymorphisms linked to response bias in PRT on depression diagnosis. The C allele in rs1042044 was significantly associated with increased PRT response bias, when controlling for age, sex, case-control status and PRT discriminability. AA genotype of rs1042044 showed higher anhedonia phenotype based on SHAPS scores. However, analysis of PGC major depressive disorder data showed no association between rs1042044 and depression diagnosis. Findings suggest a possible association of rs1042044 with anhedonia but no association with depression diagnosis.

The influence of negative and affective symptoms on anhedonia self-report in schizophrenia

BackgroundAnhedonia, a symptom prevalent in schizophrenia patients, is thought to arise either within negative symptomatology or from secondary sources, such as depression. The common co-occurrence of these diseases complicates the assessment of anhedonia in schizophrenia. MethodIn a sample of 40 outpatients with chronic schizophrenia, we explored both the validity of the Snaith-Hamilton Pleasure Scale (SHAPS) self-report for anhedonia assessment and those factors influenced its scoring. We assessed negative symptoms using the Brief Negative Symptom Scale (BNSS), depression symptoms using the Calgary Depression Scale for Schizophrenia (CDSS) and cognitive impairment using the Brief Assessment of Cognition in Schizophrenia (BACS), before exploring associations between these scales. ResultsThe SHAPS was validated for use in schizophrenia. SHAPS scores were not associated with negative symptoms or cognitive impairment, but were linked to a single Depression symptom: Hopelessness (r = 0.52, p < 0.001). ConclusionsSHAPS scores, therefore, appear to only reflect anticipatory anhedonia arising from the affective domain. We advocate the development of multi-faceted self-report measures to more holistically assess anhedonia in schizophrenia.