Anhedonia predicts poorer recovery among youth with selective serotonin reuptake inhibitor treatment-resistant depression
Open accessAbstract
Objective To identify symptom dimensions of depression that predict recovery among selective serotonin reuptake inhibitor (SSRI) treatment-resistant adolescents undergoing second-step treatment.Method The Treatment of Resistant Depression in Adolescents (TORDIA) trial included 334 SSRI treatment-resistant youth randomized to a medication switch, or a medication switch plus CBT. This study examined five established symptom dimensions (Child Depression Rating Scale-Revised) at baseline as they predicted recovery over 24 weeks of acute and continuation treatment. The two indices of recovery that were evaluated were time to remission and number of depression-free days.Results Multivariate analyses examining all five depression symptom dimensions simultaneously indicated that anhedonia was the only dimension to predict a longer time to remission, and also the only dimension to predict fewer depression-free days. In addition, when anhedonia and CDRS-total score were evaluated simultaneously, anhedonia continued to uniquely predict longer time to remission and fewer depression-free days.Conclusions Anhedonia may represent an important negative prognostic indicator among treatment-resistant depressed adolescents. Further research is needed to elucidate neurobehavioral underpinnings of anhedonia, and to test treatments that target anhedonia in the context of overall treatment of depression.
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Anhedonia is a negative prognostic factor for treatment outcome in adolescents and adults.
“Furthermore, it was shown that anhedonia is a negative prognostic factor for treatment outcome both in adolescents (McMakin et al., 2012) and adults (Spijker et al., 2001; Vrieze et al., 2014).”
From Circuit Mechanisms of Reward, Anhedonia, and Depression (2019) · cites this paper as McMakin et al., 2012
Anhedonia typically does not respond to first-line pharmacotherapies.
“Anhedonia typically does not respond to first-line pharmacotherapies [5, 7, 8]”
From Chronic unpredictable stress induces depression-related behaviors by suppressing AgRP neuron activity (2021) · cites this paper as [7]
Persistent, trait-like social anhedonia in early adolescence predicts increased severity of, and poorer recovery from, depression, above and beyond other illness features.
“Indeed, persistent, trait-like social anhedonia in early adolescence predicts increased severity of, and poorer recovery from, depression, above and beyond other illness features (184)”
From A transdiagnostic perspective on social anhedonia (2019) · cites this paper as [184]
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- Authors
- McMakin, D. L., Olino, T. M., Porta, G., Dietz, L. J., Emslie, G., Clarke, G., Wagner, K. D., Asarnow, J. R., Ryan, N. D., Birmaher, B., Shamseddeen, W., Mayes, T., Kennard, B., Spirito, A., Keller, M., Lynch, F. L., Dickerson, J. F., & Brent, D. A.
- Affiliations
- University of Pittsburgh (US)
- The University of Texas Southwestern Medical Center (US)
- Kaiser Permanente (US)
- The University of Texas Medical Branch at Galveston (US)
- University of California, Los Angeles (US)
- Rosalind Franklin University of Medicine and Science (US)
- Brown University (US)
- Corresponding author
- McMakin, Dana L.
- ORCID
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2012-04
- Volume
- 51
- Issue
- 4
- Pages
- 404-411
- ISSN
- 0890-8567 (ISSN-L)
- PMC
- PMC3536476
- OpenAlex
- W2065796254
- Cited by
- 448
- References
- 37
- Citations by year
- 2026: 23 · 2025: 50 · 2024: 52 · 2023: 33 · 2022: 45 · 2021: 53 · 2020: 39 · 2019: 41 · 2018: 23 · 2017: 18 · 2016: 18 · 2015: 17 · 2014: 23 · 2013: 11 · 2012: 2
- FWCI
- 12.45
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Health and Human Services
- Bristol-Myers Squibb
- Eli Lilly and Company
- Pfizer
- GlaxoSmithKline
- Kaiser Permanente
- University of Pittsburgh
- Melissa Institute for Violence Prevention and Treatment
- Valeant Pharmaceuticals International
- Rosalind Franklin University of Medicine and Science
- H. Lundbeck A/S
- National Institutes of Health
- University of California, Los Angeles (MH61958, MH66371, MH61869, MH62014)
- National Institute of Mental Health (MH61958, U01MH061856, MH-66371, U01MH061835, U01MH061869, MH-61869, U01MH062014, K01MH092603, MH61856, MH-61835, MH61864, K23MH092400, U01MH061958, P30MH066371, T32MH018951, U01MH061864, MH62014)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- anhedonia, treatment-resistant depression, adolescent depression, selective serotonin reuptake inhibitors, prognostic factors, remission, cognitive behavioral therapy
- MeSH terms
- Venlafaxine Hydrochloride, Adolescent, Affect, Combined Modality Therapy, Cyclohexanols, Major Depressive Disorder, Double-Blind Method, Drug Resistance, Female, Humans, Longitudinal Studies, Male, Personality Assessment, Psychometrics, Psychotherapy, Cognitive Behavioral Therapy, Selective Serotonin Reuptake Inhibitors, Antidepressive Agents, Second-Generation, Drug Substitution, Anhedonia, Depressive Disorder, Treatment-Resistant
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