Anhedonia in Major Depressive Disorder: Understanding Patient Burden


The relationship of this key symptom of major depressive disorder and patient burden is not well understood. These two posters covered it.




Anhedonia, or the loss of ability to feel pleasure, is a common symptom of depressive disorders in general. It is a key symptom and one of the diagnostic criteria of major depressive disorder (MDD) per the DSM-V, potentially caused by a decrease in activation of the ventral striatum.1 Despite its commonality, the relationship between anhedonia and patient burden is not well understood. Two posters at 2023 Psych Congress sought to explore this symptom further and its effects on patients who experience it.

One study interviewed 15 US adults with a clinician-confirmed diagnosis of MDD and anhedonia via telephone. The interviews assessed the participants’ experiences of MDD and anhedonia, and the most commonly experience of anhedonia reported by participants was lack of motivation. Mean age of participants was 52.7 years, and 67% were female. Patients reported varied degrees of deficits in interest, motivation, effort, consummatory pleasure, reward processing. They also reported that the following aspects of their lives were impacted by anhedonia: social activities (n=13), daily activities (n=11), sensory experiences (n=10), hobbies (n=9), work (n=9), family (n=8), food and drink (n=3), and romantic relationships (n=3). This demonstrates the direct and widespread impacts of anhedonia on patients’ day-to-day lives. The presenters suggested future research on MDD should comprehensively include anhedonia assessment.2

The second presentation centered on the relationship between anhedonia and burden. Investigators found that higher levels of anhedonia were associated with greater clinical and humanistic burden. The 2022 US National Health and Wellness Survey (NHWS) identified adults diagnosed with depression, who were recontacted by investigators to participate in an online survey about anhedonia; 8270 individuals with depression responded. Of those 8270 participants, 665 completed the survey. The Snaith-Hamilton Pleasure Scale (SHAPS) assessed the participants’ ability to feel pleasure, while controlling for age, sex, race, comorbidity burden, and insurance status. The mean SHAPS score was 25.4, with the range being 14 to 47. A higher SHAPS score is associated with increased levels of anhedonia and with greater depression severity (r=0.24, p<0.001), as well as increased levels of anxiety, poorer functioning, lower quality of life, and greater impairment to both work and nonwork activity. Investigators determined the results indicate a need for targeted anhedonia treatment for patients with MDD in order to achieve improved outcomes and better quality of life.3

Learn about new and emerging therapies to improve outcomes for patients with major depressive disorder at the 2023 Annual Psychiatric Times World CME Conference on October 19-21, 2023. Register here.


1. Guo L. Anhedonia. Osmosis by Elsevier. Accessed September 8, 2023.

2. Rozjabek HM, Macey J, Marshall C, et al. Qualitative study to assess the patient perspective on anhedonia symptoms and impacts in major depressive disorder. Poster presented at the 2023 Psych Congress; September 6-10, 2023. Nashville, TN.

3. Kale H, Drissen T, Cambron-Mellott J, et al. Association between anhedonia severity and clinical and humanistic outcomes among us adults with major depressive disorder. Poster presented at the 2023 Psych Congress; September 6-10, 2023. Nashville, TN.

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