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Anhedonia predicts poor psychosocial functioning: Results from a large cohort of patients treated for major depressive disorder by general practitioners
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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“and improvement of anhedonia is a strong predictor for improvement in psychosocial functioning (Vinckier et al., 2017).”
From Circuit Mechanisms of Reward, Anhedonia, and Depression (2019) · cites this paper as Vinckier et al., 2017
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Circuit Mechanisms of Reward, Anhedonia, and Depression
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“Conversely, improvement of anhedonia was shown to significantly correlate with improvement of overall functioning in depressed patients (Llorca and Gourion, 2015), and improvement of anhedonia is a strong predictor for improvement in psycho-social functioning (Vinckier et al., 2017).”
BackgroundReward-Processing Behavior in Depressed Participants Relative to Healthy Volunteers
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“Based on the impact of anhedonia on quality of life and functional outcomes in MDD, a better understanding of the effects of available antidepressants on measures of anhedonia would be clinically useful (Vinckier et al., 2017).”
BackgroundAnhedonia and Depressive Disorders
Serretti, A. (2023) · Clinical Psychopharmacology and Neuroscience · doi:10.9758/cpn.23.1086 · Cited by 169
“Agomelatine [42,77-81] *** Vortioxetine [82-86] *** Ketamine [50,90] *** Transcranial magnetic stimulation [94-98] *** Psylocibine [92] ** Bupropion (with or without dextromethorphan) [66,67,70] ** Sertraline and fluoxetine [74,75] ** Venlafaxine [76] ** Methylphenidate [93] ** Cognitive-behavioral therapy, behavioral…”
The efficacy of vortioxetine on anhedonia in patients with major depressive disorder
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“For the logistic regression analyses, clinical response for anhedonia was defined as having a SHAPS score improvement of ≥50% from baseline, and remission of anhedonia was defined as having a follow-up SHAPS score of ≤3 (19).”
MethodResultInfluential
Metadata
- Authors
- Vinckier, F., Gourion, D., & Mouchabac, S.
- Affiliations
- Sorbonne Paris Cité (FR)
- Sorbonne Université (FR)
- Corresponding author
- Vinckier, F.
- Venue
- European Psychiatry
- Publisher
- Cambridge University Press (CUP)
- Published
- 2017-07
- Volume
- 44
- Pages
- 1-8
- ISSN
- 0924-9338 (ISSN-L)
- 1778-3585
- 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
- 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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