Cited by 201Treatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health Treatment and Access

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Anhedonia predicts poor psychosocial functioning: Results from a large cohort of patients treated for major depressive disorder by general practitioners

Vinckier, F., Gourion, D., Mouchabac, S.·2017·European Psychiatry

DOI 10.1016/j.eurpsy.2017.02.485

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Abstract

BACKGROUND: Anhedonia is a core symptom of major depression and a key prognostic factor that is often poorly explored in clinical trials of major depressive disorder (MDD). Beyond symptomatic remission, psychosocial functioning also reveals difficulty in achieving remission in patients with MDD. The main objective of this study was to explore the interrelationships between social functioning and anhedonia on a longitudinal basis. METHODS: In total, 1570 outpatients treated for MDD with agomelatine were included. Severity of depression and levels of anhedonia and of psychosocial functioning were assessed at inclusion and at 10-14 weeks, with specific standardized scales (MADRS, QFS, SHAPS, CGI). Multivariate regression and mediation analyses were performed. RESULTS: Using multivariate regression, we showed that improvement of anhedonia was the strongest predictor of improvement in psychosocial functioning (odds ratio=7.3 [4.3-12.1] P<0.0001). In addition, mediation tests confirmed that the association between improvement of depressive symptoms and improvement of social functioning was significantly underpinned by the improvement of anhedonia over time. Finally, we explored the determinants of the dissociation of the response, i.e., the persistence of psychosocial dysfunctioning despite a symptomatic response to antidepressant treatment, which remains a widespread situation in clinical practice. We showed that this dissociation was strongly predicted by persistence of anhedonia. CONCLUSION: Our results suggest that anhedonia is one of the strongest predictors of psychosocial functioning, along with symptomatic remission, and should be carefully assessed by health professionals, in order to optimize pharmacological as well as non-pharmacological management of depression.

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Background
Efficacy of transcranial direct current stimulation for treating anhedonia in patients with depression: A randomized, double-blind, sham-controlled clinical trial
Kong, S., Chen, Y., Huang, H., Yang, W., Lyu, D., Wang, F., Huang, Q., Zhang, M., Chen, S., Wei, Z., et al. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.01.041 · Cited by 18
Working memory training can improve anhedonia in college students with subsyndromal depressive symptoms
Zhang, Y., Wang, H., Yan, C., Wang, L., Cheung, E. F. C., & Chan, R. C. K. (2019) · PsyCh Journal · doi:10.1002/pchj.271 · Cited by 18
Self-evaluation of negative symptoms in adolescent and young adult first psychiatric episodes.
Mallet, J., Guessoum, S., Tebeka, S., Strat, Y. L., & Dubertret, C. (2020) · Progress in Neuro-psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2020.109988 · Cited by 14
Trajectories of state anhedonia and recent changes in anhedonia in college students: Associations with other psychiatric syndromes
Yang, X., Wang, D., Liu, S., Liu, G., & Harrison, P. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.11.043 · Cited by 15
The impacts of anhedonia on brain functional alterations in patients with major depressive disorder: A resting-state functional magnetic resonance imaging study of regional homogeneity
Fang, Z., Mu, Q., Wu, C., Jia, L., Wang, Z., Hu, S., Xu, Y., Huang, M., & Lu, S. (2022) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2022.10.028 · Cited by 15
Social Interpretation Inflexibility and Functioning: Associations with Symptoms and Stress
Deng, W., Everaert, J., Bronstein, M. V., Joormann, J., & Cannon, T. D. (2023) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.2023.42.1.29 · Cited by 15
Recalling and anticipating positive events to improve the positive affect and mental health of adolescents: A cluster randomized controlled trial in secondary schools
Bogaert, L., Hallford, D. J., Loyen, E., D’Argembeau, A., & Raes, F. (2024) · Behaviour Research and Therapy · doi:10.1016/j.brat.2024.104543 · Cited by 18
Effect of venlafaxine on anhedonia and amotivation in patients with major depressive disorder
McIntyre, R. S., Agid, O., Biesheuvel, E., & Purushottamahanti, P. (2024) · CNS Spectrums · doi:10.1017/s1092852924000245 · Cited by 13
Effect of DLPFC rTMS on anhedonia and alpha asymmetry in depressed patients
Kazemi, R., Rostami, R., Hadipour, A., Zandbagleh, A., Khomami, S., Kiaee, N., Coetzee, J. P., Philips, A., & Adamson, M. M. (2025) · Scientific Reports · doi:10.1038/s41598-024-85057-w · Cited by 11
“not considered a symptom exclusive to MDD. Anhedonia has been found to be a predictor of poor psychosocial functioning 20 and treatment outcomes after pharmacotherapy 21,22 , psychotherapy 23 , and rTMS treatment 24 .”
Agomelatine Effectiveness, Tolerability, and Impact on Anhedonia in Major Depression
Giannantonio, M. D., Montemitro, C., Sepede, G., Brunetti, M., Baroni, G., Corbo, M., Anders, M., Tavčar, R., Martinotti, G., & Manzoli, L. (2019) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000001038 · Cited by 13
White matter microstructure associated with anhedonia among individuals with bipolar disorders and high-risk for bipolar disorders
Díaz, A. P., Fernandes, B. S., Teixeira, A. L., Mwangi, B., Hasan, K. M., Wu, M., Selvaraj, S., Suen, P. J. C., Zanao, T. A., Brunoni, A. R., et al. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.12.037 · Cited by 13
Association between Neuroticism and Premenstrual Affective/Psychological Symptomatology
Hamidovic, A., Dang, N., Khalil, D., & Sun, J. (2022) · Psychiatry International · doi:10.3390/psychiatryint3010005 · Cited by 10
“It is a significant predictor of psychosocial functioning [52].”
Background
A Delphi consensus on clinical features, diagnosis and treatment of major depressive disorder patients with anhedonia amongst psychiatrists in the Asia-Pacific
Cheng, C. P. W., Herr, K. J., Jeon, H. J., Kato, T., Ng, C. H., Yang, Y. K., & Zhang, L. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1338063 · Cited by 12
Navacaprant, a Novel and Highly Selective Kappa Opioid Receptor Antagonist, in Adults With Major Depressive Disorder
Mathew, S. J., Cutler, A. J., Visitacion, N. C., Gold, M., Yuan, J. X. ‐., & Aurora, B. (2025) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000001967 · Cited by 14
The Impact of Negative Symptoms and Neurocognition on Functioning in MDD and Schizophrenia
Quek, Y. F., Yang, Z., Dauwels, J., & Lee, J. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.648108 · Cited by 12
“A past study (57) has found that anhedonia is a strong predictor of psychosocial functioning in depressed patients.”
Background
Inflammatory cytokines, cortisol, and anhedonia in patients with treatment-resistant depression after consecutive infusions of low-dose esketamine
Wang, Y., Yang, Q., Chen, C., Yao, Y., Yuan, X., & Zhang, K. (2024) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-024-01913-w · Cited by 11
“MDD patients with anhedonia are also strongly associated with greater levels of social withdrawal and social impairment [4], and the appearance of anhedonia makes it more challenging for TRD patients to achieve functional recovery [5].”
Metabolic factors modulate effort-based decision-making in major depressive disorder
Gill, H., Badulescu, S., Vincenzo, J. D. D., Tabassum, A., Mckenzie, A., Shah, H., Amin, M., Llach, C.-D., Rosenblat, J. D., McIntyre, R. S., et al. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.12.090 · Cited by 12
Effects of High Frequency Repetitive Transcranial Magnetic Stimulation (HF-rTMS) on Delay Discounting in Major Depressive Disorder: An Open-Label Uncontrolled Pilot Study
Mayer, J. T., Nicolier, M., Tio, G., Mouchabac, S., Haffen, É., & Bennabi, D. (2019) · Brain Sciences · doi:10.3390/brainsci9090230 · Cited by 11
“This pattern has been related to anhedonia, which is a strong mediator for functional remission of depression [5] and could be predictive of suicide attempt lethality among depressed individuals [6,7].”
Positive Affect Treatment for Depression and Anxiety
Craske, M. G., Dour, H. J., Treanor, M., & Meuret, A. E. (2022) · doi:10.1093/med-psych/9780197548523.001.0001 · Cited by 11
Volume changes of the subcortical limbic structures in major depressive disorder patients with and without anhedonia
Mu, Q., Cui, D., Zhang, K., Ru, Y., Wu, C., Fang, Z., Jia, L., Hu, S., Huang, M., & Lu, S. (2023) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2023.111747 · Cited by 10
A parallel-arm, randomized trial of Behavioral Activation Therapy for anhedonia versus mindfulness-based cognitive therapy for adults with anhedonia
Cernasov, P., Walsh, E. C., Nagy, G. A., Kinard, J. L., Kelley, L., Phillips, R., Pisoni, A., Diehl, J. M., Haworth, K., West, J. S., et al. (2024) · Behaviour Research and Therapy · doi:10.1016/j.brat.2024.104620 · Cited by 11
“Do depressive and manic symptoms differentially impact on functioning in acute depression? Results from a large, cross-sectional study”
Anmella, G., Gil-Badenes, J., Pacchiarotti, I., Verdolini, N., Aedo, A., Angst, J., Azorin, J., Bowden, C. L., Mosolov, S. N., Samalin, L., et al. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.09.070 · Cited by 10
Anhedonia in depression: neurobiological and genetic aspects
Kibitov, A. O., & Mazo, G. E. (2021) · S S Korsakov Journal of Neurology and Psychiatry · doi:10.17116/jnevro2021121031146 · Cited by 11
Restoration of psychosocial functioning in remitted major depressive disorder patients: A 1-year longitudinal study
Wang, Z., Qu, H., Zhong, J., Han, Y., Wan, C., Wang, H., Yang, H., Lu, S., Diao, K., Zhang, N., et al. (2020) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2020.152204 · Cited by 10
Validation of the Chinese Dimensional Anhedonia Rating Scale in Depressed Patients in Hong Kong
Ching, E. W.-K., Chiang, T. P., Wong, J. O. Y., Siu, B. W. M., Cheng, K. M., Lui, S. S. Y., & Cheung, E. F. C. (2021) · Psychological Test Adaptation and Development · doi:10.1027/2698-1866/a000012 · Cited by 9
Psychometric properties of the Dimensional Anhedonia Rating Scale in Chinese typical, subthreshold, and clinically depressed adolescents
Xiao, W., Zhu, R., Lv, Z., Fan, J., Yi, Z., Chen, J., Ju, K., & Yan, C. (2022) · PsyCh Journal · doi:10.1002/pchj.517 · Cited by 9
Anhedonia and sensitivity to punishment in schizophrenia, depression and opiate use disorder
Ossola, P., Garrett, N., Biso, L., Bishara, A. J., & Marchesi, C. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.02.120 · Cited by 10
Effect of Cariprazine on Anhedonia in Patients with Bipolar I Depression: Post Hoc Analysis of Three Randomized Placebo-Controlled Clinical Trials
McIntyre, R. S., Llorca, P., Aronin, L. C., Yu, J., & Nguyen, H. (2024) · Advances in Therapy · doi:10.1007/s12325-024-03009-2 · Cited by 8
Abnormal Structure–Function Coupling in Major Depressive Disorder Patients With and Without Anhedonia
Mu, Q., Wu, C., Chen, Y., Xu, Y., Zhang, K., Zhu, C., Hu, S., Huang, M., Zhang, P., Cui, D., et al. (2025) · Depression and Anxiety · doi:10.1155/da/1925158 · Cited by 8
“It is notable that anhedonia typically persists following the improvement of other symptoms, seriously affecting the recovery of social functioning [5 – 7].”
Influential
The effect of adjunctive cariprazine on symptoms of anhedonia in patients with major depressive disorder
McIntyre, R. S., Maletic, V., Masand, P. S., Wilson, A. C., Yu, J., Adams, J. L., & Kerolous, M. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.05.026 · Cited by 10
Positive Affect Treatment for Depression, Anxiety, and Low Positive Affect
Meuret, A. E., Rosenfield, D., Wang, E., Hough, C. M., Ritz, T., & Craske, M. G. (2026) · JAMA Network Open · doi:10.1001/jamanetworkopen.2026.7403 · Cited by 9
Parental Symptoms of Anhedonia, Parenting, and Youth Outcomes: A Multi-Method, Multi-Informant Investigation
Griffith, J. M., Young, J. F., & Hankin, B. L. (2023) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-023-01130-4 · Cited by 9
“…the criterial symptoms of depression and is associated with a host of negative correlates and outcomes, including impaired psychosocial functioning (Vinckier et al., 2017), reduced treatment response (Burkhouse et al., 2018; Khazanov et al., 2020; McMakin et al., 2012), more chronic and severe…”
Add-on pramipexole for anhedonic depression: study protocol for a randomised controlled trial and open-label follow-up in Lund, Sweden
Lindahl, J., Asp, M., Ståhl, D., Tjernberg, J., Eklund, M., Björkstrand, J., van Westen, D., Jensen, J., Månsson, K. N. T., Tornberg, Å. B., et al. (2023) · BMJ Open · doi:10.1136/bmjopen-2023-076900 · Cited by 8
Determining cut-off values and predictors for the Snaith–Hamilton Pleasure Scale: comparison between clinical and school settings
Ho, Y., Gau, S. S., Wu, Y.-S., Chen, C.-H., Wang, J.-K., Lee, H., Chung, K., Chiu, Y.-H., Goh, K. K., Lu, M., et al. (2024) · BJPsych Open · doi:10.1192/bjo.2024.35 · Cited by 8
Effects of Transcranial Pulse Stimulation (TPS) on Young Adults With Symptom of Depression: A Pilot Randomised Controlled Trial Protocol
Cheung, T. C. C., Ho, J. Y. S., Yeung, J. W.-F., Leung, S. F., Fong, T. K. H., Fong, T. K. H., Kranz, G. S., Beisteiner, R., & Cheng, C. P. W. (2022) · Frontiers in Neurology · doi:10.3389/fneur.2022.861214 · Cited by 8
Intrinsic and extrinsic control impact motivation and outcome sensitivity: the role of anhedonia, stress, and anxiety
Mehta, M., Butler, G., Ahn, C., Whitaker, Y. I., Bachi, K., Jacob, Y., Treadway, M. T., Murrough, J. W., & Morris, L. S. (2024) · Psychological Medicine · doi:10.1017/s0033291724002022 · Cited by 7
“…example, a lack of interest, enjoyment, or motivation for previously pleasur-able activities, is a core symptom of depression, and is associated with an additional risk of poorer outcomes and morbidity (Ducasse et al., 2018; Leroy, Loas, & Perez-Diaz, 2010; Vinckier, Gourion, & Mouchabac, 2017).”
Effects of estradiol administration on brain activation and anhedonia in perimenopausal women: A pharmaco-fMRI study
Walsh, E. C., Prim, J., Gibson, K., Hynd, M., Phillips, R. D., Dichter, G. S., Nathan, M., Lundegard, L. C., Schiff, L. D., Bizzell, J., et al. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.01.033 · Cited by 7
A Narrative Review on Toxidromes in the Psychiatric Population: Implications for Overdose Prevention
Dutta, S., Buciuc, A. G., Barry, P., & Padilla, V. L. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14176160 · Cited by 7
“Meta-analytic and cohort findings show anhedonia predicts worse psychosocial and functional outcomes, consistent with reduced engagement with protective factors [38,39].”
Exploring mechanisms of anhedonia in depression through neuroimaging and data-driven approaches
Wang, W., Zhou, E., Nie, Z., Deng, Z., Gong, Q., Ma, S., Kang, L., Yao, L., Cheng, J., & Liu, Z. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.07.133 · Cited by 7
Association between inflammation, reward processing, and ibuprofen-induced increases of miR-23b in astrocyte-enriched extracellular vesicles: A randomized, placebo-controlled, double-blind, exploratory trial in healthy individuals
Burrows, K., Figueroa‐Hall, L. K., Alarbi, A. M., Stewart, J. L., Kuplicki, R., Tan, C., Hannafon, B. N., Ramesh, R., Savitz, J. B., Khalsa, S. S., et al. (2022) · Brain Behavior & Immunity - Health · doi:10.1016/j.bbih.2022.100582 · Cited by 7
“…treatment outcomes in clinical populations, such that individuals with MDD display deficits in brain reward processing in the form of decreased activity of ventral striatum (VS) (Epstein et al., 2006; Husain and Roiser, 2018; Pizzagalli et al., 2009; Takamura et al., 2017; Vinckier et al., 2017).”
Anhedonia in Major Depressive Disorder: Prevalence and Treatment Expectations and Satisfaction with Treatment Goals Among Patients and Physicians in Asia-Pacific
Herr, K. J., Berk, M., Huang, W.-L., Kato, T., Lee, J. G., Ng, C. G., Wang, Z., Webb, T., Kasahara‐Kiritani, M., & Vandervoort, L. (2024) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s487747 · Cited by 6
Altered local spontaneous activity and functional connectivity density in major depressive disorder patients with anhedonia
Wu, C., Mu, Q., Xu, Y., Chen, Y., Zhang, P., Cui, D., & Lu, S. (2025) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2025.104380 · Cited by 6
The Leuven Exeter Dampening Scale (LEDS) to measure dampening appraisals towards positive affect: Psychometric evaluation and initial validation in a Dutch and English community sample.
Bogaert, L., Lau, H., Dunn, B., & Raes, F. (2025) · Behaviour Research and Therapy · doi:10.1016/j.brat.2025.104861 · Cited by 6
Assessing Anhedonia in Adolescents: The Psychometric Properties and Validity of the Dimensional Anhedonia Rating Scale
Hewitt, J. M. A., Zareian, B., & LeMoult, J. (2023) · The Journal of Early Adolescence · doi:10.1177/02724316231207290 · Cited by 6
“For example, consummatory anhedonia predicts poor psychosocial functioning (Vinckier et al., 2017), whereas anticipatory an-hedonia has been associated with depressive symptoms (Ho et al., 2015).”
Background
Antidepressant-like effect of riparin I and riparin II against CUMS-induced neuroinflammation via astrocytes and microglia modulation in mice
Lopes, I. S., Souza, A. G., Filho, A. J. M. C., Sampaio, T. L., da Silva, D. M. A., Valentim, J. T., Chaves, R. D. C., Soares, M. V. R., Júnior, D. C. C., Barbosa‐Filho, J. M., et al. (2024) · Behavioural Pharmacology · doi:10.1097/fbp.0000000000000788 · Cited by 7
“…potential, since the social deficit in depressive patients can persist even after remission of affective symptoms, impairing the individual’s quality of life and favoring the occurrence of new depressive conditions (Gilhotra and Dhingra, 2010; Llerena et al. , 2012; Vinckier et al. , 2017).”
Advances in optogenetic studies of depressive-like behaviors and underlying neural circuit mechanisms
Lin, S., Du, Y., Xia, Y., Xie, Y., Xiao, L., & Wang, G. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.950910 · Cited by 7
“Besides improvement of anhedonia significantly correlates with better overall functioning in depressed patients and is a strong prediction for psychiatrical functioning improvement (38, 39), which emphasizes its critical role in depression.”
Background

Authors: Vinckier, F., Gourion, D., & Mouchabac, S.
Affiliations: Sorbonne Paris Cité (FR)
Sorbonne Université (FR)
Corresponding author: Vinckier, F.
ORCID: Vinckier, F.
Mouchabac, S.
Venue: European Psychiatry
Publisher: Cambridge University Press (CUP)
Published: 2017-07
Volume: 44
Pages: 1-8
ISSN: 0924-9338 (ISSN-L)
1778-3585
DOI: 10.1016/j.eurpsy.2017.02.485
OpenAlex: W2592834759
Cited by: 201
References: 43
Citations by year: 2026: 22 · 2025: 44 · 2024: 29 · 2023: 22 · 2022: 35 · 2021: 16 · 2020: 13 · 2019: 14 · 2018: 4 · 2017: 2
FWCI: 6.30
Type: journal article
Language: en
Open access: closed
Licence: www.cambridge.org/core/terms (unspecified, 996 d)
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: European Psychiatry (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Keywords: anhedonia, major depressive disorder, psychosocial functioning, social functioning, agomelatine, antidepressant response, prognostic factors, general practitioners, mediation analysis
MeSH terms: Adaptation, Psychological, Adult, Antidepressive Agents, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Outpatients, Severity of Illness Index, Social Adjustment, Cohort Studies, Treatment Outcome, General Practitioners, Anhedonia

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Anhedonia predicts poor psychosocial functioning: Results from a large cohort of patients treated for major depressive disorder by general practitioners

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