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Anhedonia in Depression and Bipolar Disorder

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Anhedonia: Preclinical, Translational, and Clinical Integration

Part of the book series: Current Topics in Behavioral Neurosciences ((CTBN,volume 58))

Abstract

Anhedonia is a hallmark feature of depression and is highly prevalent among individuals with mood disorders. The history and neurobiology of anhedonia has been most extensively studied in the context of unipolar Major Depressive Disorder (MDD), with converging lines of evidence indicating that marked anhedonia heralds a more chronic and treatment-refractory illness course. Furthermore, findings from neuroimaging studies suggest that anhedonia in MDD is associated with aberrant reward-related activation in key brain reward regions, particularly blunted reward anticipation-related activation in the ventral striatum. However, the ongoing clinical challenge of treating anhedonia in the context of Bipolar Disorder (BD) also highlights important gaps in our understanding of anhedonia’s prevalence, severity, and pathophysiology along the entire mood disorder spectrum. In addition, although current theoretical models posit a key role for reward hyposensitivity in BD depression, unlike studies in MDD, studies in BD do not clearly show evidence for reduced reward-related activation in striatal or other brain regions. Although further research is needed, the evidence to date hints at a divergent pathophysiology for anhedonia in unipolar and bipolar mood disorders, which, if better understood, could lead to significant improvements in the diagnosis and treatment of MDD and BD.

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  1. Black Dog Institute, University of New South Wales, Sydney, NSW, Australia

    Alexis E. Whitton

  2. Center for Depression, Anxiety and Stress Research, McLean Hospital & Harvard Medical School, Belmont, MA, USA

    Diego A. Pizzagalli

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    Diego A. Pizzagalli

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Whitton, A.E., Pizzagalli, D.A. (2022). Anhedonia in Depression and Bipolar Disorder. In: Pizzagalli, D.A. (eds) Anhedonia: Preclinical, Translational, and Clinical Integration. Current Topics in Behavioral Neurosciences, vol 58. Springer, Cham. https://doi.org/10.1007/7854_2022_323

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