Anhedonia as a Crucial Factor of Depression: Assessment, Neurobiological Underpinnings and Treatment
Anhedonia is a cardinal symptom of major depressive disorder yet has not received significant attention in the research domain. A major contributor to this disproportionality is the limited understanding of anhedonia. Traditionally conceptualized as a “loss of pleasure”, it is clear that anhedonia includes additional facets including interest, motivation and reward learning. With the construct of anhedonia expanded, the development of new assessment tools, including self-report scales and behavioural tasks, has greatly improved our understanding of the underlying neurobiology. Deficits in nucleus accumbens activity have historically been tied to anhedonia due to its attribution as a “pleasure centre” in the brain. However, it is now known that many other brain regions are involved in the processing of reward. Furthermore, many first-line antidepressant options focus primarily on potentiating serotonin levels, despite dopamine playing an essential role in anhedonia. A greater understanding of anhedonia may allow for more personalized treatment strategies and heavily reduce the significant burden associated with depression. This chapter will review the neurobiology, measurement and treatment of this core symptom of MDD.
KeywordsAnhedonia Reward processing Neurobiology Major depressive disorder Treatment Assessment
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