The characteristics of anhedonia in depression: a review from a clinically oriented perspective

Abstract Anhedonia, as one of the core symptoms of major depressive disorder (MDD), has been regarded as a potential endophenotype of the disease. Multiple studies have evaluated the potential mechanisms of anhedonia in MDD, and found that MDD patients with anhedonia showed different functions in cl...

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Main Authors: Congchong Wu, Qingli Mu, Weijia Gao, Shaojia Lu
Format: Article
Language:English
Published: Nature Publishing Group 2025-03-01
Series:Translational Psychiatry
Online Access:https://doi.org/10.1038/s41398-025-03310-w
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author Congchong Wu
Qingli Mu
Weijia Gao
Shaojia Lu
author_facet Congchong Wu
Qingli Mu
Weijia Gao
Shaojia Lu
author_sort Congchong Wu
collection DOAJ
description Abstract Anhedonia, as one of the core symptoms of major depressive disorder (MDD), has been regarded as a potential endophenotype of the disease. Multiple studies have evaluated the potential mechanisms of anhedonia in MDD, and found that MDD patients with anhedonia showed different functions in clinical features. In this review, we focus on the clinical research to explore the differences between MDD patients with and without anhedonia in the clinical manifestations and biological alterations, and elaborate the treatments and prognosis of anhedonia. It is demonstrated that anhedonia is associated with adverse outcomes including more severe depressive episode and suicidality, and poor prognosis in patients with MDD. At the biological level, MDD patients with anhedonia seem to present higher levels of inflammatory factors, abnormal metabolic function and hypermetabolism of BDNF. In brain imaging studies, there are some structural and/ or functional changes in multiple brain regions of subcortical and cortical areas, as well as the limbic system in MDD patients with anhedonia. Meanwhile, preliminary research findings have also indicated that there are associations between intestinal flora imbalance and anhedonia. Moreover, evidence indicated the benefit of some selective serotonin reuptake inhibitors seemed limited on anhedonia, and other treatments including psychotherapy, physical therapy and probiotic interventions has remained to be explored but has interesting potential. Therefore, increased awareness of the anhedonic symptoms and the unique clinical features would benefit improved early diagnosis and therapeutic effects in MDD.
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spelling doaj-art-ca861a28014f43699f54b4396fb4962d2025-08-20T03:41:43ZengNature Publishing GroupTranslational Psychiatry2158-31882025-03-011511910.1038/s41398-025-03310-wThe characteristics of anhedonia in depression: a review from a clinically oriented perspectiveCongchong Wu0Qingli Mu1Weijia Gao2Shaojia Lu3Department of Child Psychology, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical CenterDepartment of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang Key Laboratory of Precision Psychiatry, Zhejiang Engineering Center for Mathematical Mental HealthDepartment of Child Psychology, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical CenterDepartment of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang Key Laboratory of Precision Psychiatry, Zhejiang Engineering Center for Mathematical Mental HealthAbstract Anhedonia, as one of the core symptoms of major depressive disorder (MDD), has been regarded as a potential endophenotype of the disease. Multiple studies have evaluated the potential mechanisms of anhedonia in MDD, and found that MDD patients with anhedonia showed different functions in clinical features. In this review, we focus on the clinical research to explore the differences between MDD patients with and without anhedonia in the clinical manifestations and biological alterations, and elaborate the treatments and prognosis of anhedonia. It is demonstrated that anhedonia is associated with adverse outcomes including more severe depressive episode and suicidality, and poor prognosis in patients with MDD. At the biological level, MDD patients with anhedonia seem to present higher levels of inflammatory factors, abnormal metabolic function and hypermetabolism of BDNF. In brain imaging studies, there are some structural and/ or functional changes in multiple brain regions of subcortical and cortical areas, as well as the limbic system in MDD patients with anhedonia. Meanwhile, preliminary research findings have also indicated that there are associations between intestinal flora imbalance and anhedonia. Moreover, evidence indicated the benefit of some selective serotonin reuptake inhibitors seemed limited on anhedonia, and other treatments including psychotherapy, physical therapy and probiotic interventions has remained to be explored but has interesting potential. Therefore, increased awareness of the anhedonic symptoms and the unique clinical features would benefit improved early diagnosis and therapeutic effects in MDD.https://doi.org/10.1038/s41398-025-03310-w
spellingShingle Congchong Wu
Qingli Mu
Weijia Gao
Shaojia Lu
The characteristics of anhedonia in depression: a review from a clinically oriented perspective
Translational Psychiatry
title The characteristics of anhedonia in depression: a review from a clinically oriented perspective
title_full The characteristics of anhedonia in depression: a review from a clinically oriented perspective
title_fullStr The characteristics of anhedonia in depression: a review from a clinically oriented perspective
title_full_unstemmed The characteristics of anhedonia in depression: a review from a clinically oriented perspective
title_short The characteristics of anhedonia in depression: a review from a clinically oriented perspective
title_sort characteristics of anhedonia in depression a review from a clinically oriented perspective
url https://doi.org/10.1038/s41398-025-03310-w
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