Reduced hedonic capacity in euthymic bipolar subjects: A trait-like feature?
University Consortium Humanitas, Rome, Italy. Electronic address: .Journal of Affective Disorders (Impact Factor: 3.38). 10/2012; 147(1-3). DOI: 10.1016/j.jad.2012.10.004
BACKGROUND: The aim of our study was to assess hedonic capacity in euthymic bipolar subjects, identifying possible differences compared to remitted unipolar depressed patients and healthy controls. METHODS: 107 subjects with bipolar disorders, 86 with major depressive disorder and 106 healthy controls, homogeneous with respect to demographic characteristics, were enrolled. The following scales were administered: the Snaith-Hamilton pleasure scale (SHAPS), the subscale for 'anhedonia/asociality' of the scale for the assessment of negative symptoms (SANS) and the visual analogue scale (VAS) for hedonic capacity. RESULTS: Scores on SHAPS total, interests and social interactions, SANS 'anhedonia/asociality' and VAS were all significantly higher in affective disorder patients compared to healthy controls. No difference was found between clinical groups. 20.5% (n=22) of bipolar disorder subjects and 24.5% (n=21) of major depressed subjects showed a significant reduction in hedonic capacity (SHAPS total score ≥3), compared to 7.5% (n=8) of healthy controls (χ(2)=12.03; p=.002). LIMITATIONS: Limitations include heterogeneity with respect to pharmacological status and longitudinal course (i.e., 'single' vs. 'recurrent' affective episodes). CONCLUSIONS: The major finding of our study is that euthymic bipolar patients and remitted major depressed patients display residual anhedonic symptoms. This suggests that, in affective disorder patients, altered hedonic capacity could represent an enduring trait and that, possibly, dysfunctions in the neurobiological mechanisms underlying hedonic response and reward processing persist, irrespective of mood state.
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- "This was the first study to examine negative symptoms in bipolar disorder and healthy control participants using the CAINS, a recently developed interview-based assessment of experiential and expressive negative symptoms. A few prior studies using other scales have suggested that overall negative symptoms are elevated in bipolar disorder (Toomey et al., 1998;Ameen and Ram, 2007;Di Nicola et al., 2013). The current study indicates that elevations primarily reflect disturbances in the experiential sub-domain (MAP subscale). "
ABSTRACT: Schizophrenia and bipolar disorder have been associated with shared and distinct emotion processing abnormalities. Initial findings indicate that these disorders differ with respect to the domain of emotional intelligence (EI). Individuals with schizophrenia display deficits on performance measures of EI, whereas those with bipolar disorder do not. However, no research has examined patients' subjective beliefs about their own EI (referred to as “perceived EI”). This study examined perceived EI, assessed with the Trait Meta-Mood Scale (TMMS), and its clinical and functional correlates in outpatients with schizophrenia (n = 35) or bipolar disorder I (n = 38) and matched healthy controls (n = 35). The TMMS includes three subscales that assess beliefs about one's ability to attend to (Attention to Feelings), understand (Clarity of Feelings), and repair emotions (Mood Repair). Participants in the clinical groups also completed community functioning and symptom assessments. Both clinical groups reported significantly lower perceived EI than controls, but did not differ from each other. Higher total TMMS correlated with higher levels of independent living in the schizophrenia group (r = .36) and better social functioning in the bipolar group (r = .61). In addition, although higher Attention to Feelings scores correlated with greater psychiatric symptoms in the schizophrenia group, higher scores across all subscales correlated with less manic symptoms in the bipolar group. The findings suggest that perceived EI is impaired and related to community functioning in both disorders.
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- "Researchers commonly use three categories of measures to assess anhedonia [i.e., self-report questionnaires , computerized tasks probing distinct components of reward processing, and imaging studies targeting brain activity in specific regions, predominantly the ventral striatum (VS)/nucleus accumbens (NAc)]. An abundance of psychiatric investigations, primarily in patients with schizophrenia, depression, substance dependence, and Parkinson's disease, but also in patients with bipolar disorder and PTSD, reports elevated scores on anhedonia scales (Leventhal et al., 2006; Franken et al., 2007; Assogna et al., 2011; Hatzigiakoumis et al., 2011; Di Nicola et al., 2012; Frewen et al., 2012). Although anhedonia is found in the majority of patients with major depressive disorder, it may be a distinct entity from depression as demonstrated by a plethora of studies reporting weak to moderate correlations between the two constructs (Leventhal et al., 2006; Franken et al., 2007; Nakonezny et al., 2010) among non-psychiatric controls as well as in depression and other disorders. "
ABSTRACT: Obsessive-compulsive disorder (OCD) has been linked to reward dysfunctions, highlighting a possible role of anhedonia in OCD. Surprisingly, anhedonia in OCD has never been evaluated. Moreover, although nicotine typically has anti-anhedonic effects, anecdotal reports suggest low prevalence rates of smoking in OCD. To address these two phenomena, 113 individuals with OCD completed a battery of questionnaires assessing symptom severity, anhedonia, and smoking. 28.3% of the sample met criteria for clinically significant anhedonia, which correlated with Y-BOCS scores (r=0.44), even when controlling for depressive symptoms. 13.3% of the sample endorsed current smoking, a lower rate than seen in psychiatric disorders (40–90%) and the general adult population (19%). Results highlight high rates of anhedonia and yet reduced prevalence of smoking in OCD. In contrast to the known positive association between anhedonia and smoking, a negative association emerged. Future research is needed to address the unique interface between anhedonia and reward responsiveness in OCD. Potential clinical implications are discussed.
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ABSTRACT: Major depressive disorder has been associated with blunted responsiveness to rewards, but inconsistencies exist whether such abnormalities persist after complete remission. To address this issue, across two independent studies, 47 adults with remitted major depressive disorder (rMDD) and 37 healthy controls completed a Probabilistic Reward Task, which used a differential reinforcement schedule of social or monetary feedback to examine reward responsiveness (i.e., ability to modulate behavior as a function of reinforcement history). Relative to controls, adults with rMDD showed blunted reward responsiveness. Importantly, a history of depression predicted reduced reward learning above and beyond residual depressive (including anhedonic) symptoms and perceived stress. Findings indicate that blunted reward responsiveness endures even when adults are in remission and might be a trait-related abnormality in MDD. More research is warranted to investigate if blunted reward responsiveness may predict future depressive episodes and whether targeting reward-related deficits may prevent the re-occurrence of the disorder.
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