Despite the importance of anhedonia for diagnosis and prognosis, a variety of conceptual and methodological challenges exist meaning that the symptom of anhedonia is not well understood. It may also be key to understanding suicidality, with adolescent suicide attempters reporting greater anhedonia severity than suicide ideators, even after controlling for depression and anxiety. Anhedonia has been identified as a potential predictor of poor treatment outcome in adolescents above and beyond all other depression symptoms. Between 50 and 78% of young people with a diagnosis of MDD report anhedonia in the UK. In adolescents, depressed mood/irritability or anhedonia must be present for a depression diagnosis. The first onset of MDD frequently occurs in adolescence, with up to 20% of young people experiencing a depressive episode by the age of 18. It is defined by the DSM-5 as ‘markedly diminished interest or pleasure in all, or almost all activities most of the day, nearly every day’. This highlights the potential benefit of taking a trans-diagnostic approach to understanding and treating reward deficits associated with mental health problems.Īnhedonia is a core symptom of major depressive disorder (MDD). Adolescents reported a range of experiences that mapped closely onto the cluster of negative symptoms associated with schizophrenia and were similar to the sense of ‘apathy’ characteristic in Parkinson’s disease. The results challenge the framing of anhedonia as simply the loss of interest and pleasure. Four main themes were identified: (1) experiencing a loss of joy and a flattening of emotion (2) struggling with motivation and active engagement (3) losing a sense of connection and belonging and (4) questioning sense of self, purpose, and the bigger picture. Thematic analysis was used to identify important aspects of adolescents’ experiences. Semi-structured interviews were conducted with 34 adolescents with a primary diagnosis of depression ( N = 12) or elevated depressive symptoms ( N = 22).
The aim of this study is to examine how young people experience anhedonia in the context of depression.
However, little is known about the subjective experience of anhedonia, and it is rarely targeted in psychological treatment for depression. Anhedonia (or loss of interest and pleasure) is a core symptom of depression and may predict poor treatment outcome.
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