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2015 ; 184
(ä): 81-8
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Anhedonia in melancholic and non-melancholic depressive disorders
#MMPMID26074016
Fletcher K
; Parker G
; Paterson A
; Fava M
; Iosifescu D
; Pizzagalli DA
J Affect Disord
2015[Sep]; 184
(ä): 81-8
PMID26074016
show ga
BACKGROUND: Anhedonia represents a core symptom of major depression and may be a
potential marker for melancholia. However, current understanding of this
construct in depressive sub-types is limited. METHOD: Participants were recruited
from the Black Dog Institute (Sydney) and Massachusetts General Hospital
(Boston). Diagnostic groups were derived on the basis of agreement between
clinician and DSM-IV diagnosis from structured interviews. Currently depressed
unipolar melancholic, non-melancholic and healthy control participants were
administered a probabilistic reward task (PRT) to assess a behavioural correlate
of anhedonia-blunted reward-based learning. Self-reported measures of anhedonia,
approach and avoidance motivation were completed by the Sydney sample. RESULTS:
Relative to healthy controls and non-melancholic participants, melancholic
depressed participants had reduced response bias, highlighting blunted reward
learning. Moreover, although non-melancholic participants were characterized by a
delayed response bias, melancholic depressed participants failed to develop a
bias throughout blocks. Response bias showed no associations with self-report
measures of hedonic tone in depressed participants. Positive associations were
observed between response bias, approach and avoidance motivation in
non-melancholic participants only. LIMITATIONS: Possible medication, fatigue and
anxiety effects were not controlled; small sample sizes; inclusion criteria may
have excluded those with severe melancholia and led to underestimation of group
differences. CONCLUSIONS: Melancholia is characterised by a reduced ability to
modulate behaviour as a function of reward, and the motivational salience of
rewarding stimuli may differ across depressive sub-types. Results support the
view that melancholia is a distinct sub-type. Further exploration of reward
system functioning in depressive sub-types is warranted.
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