Anhedonia and emotional blunting

Emotional blunting appears to be present in almost half of patients with depression taking antidepressants.³ One hypothesis of the cycle of anhedonia in patients with depression is shown on the slide; this hypothesis comes from a series of experiments performed on a sample of psychology students.⁶ The students were given the Beck Depression Inventory (BDI), and only those who displayed either high (BDI score >20) or low (<10) depressive symptomatology were included in the study.⁶ As well as completing a series of questionnaires, their helping behaviour was tested during the debriefing process when, in what was made to seem like an accident, a researcher dropped a pile of papers near the participant – latency to help, and the degree of help provided was used as a proxy for helping behaviour, and social anhedonia.⁶ Higher levels of participants not helping were seen in the high depressive symptomatology group.⁶

There have been attempts to assay the effectiveness of newer antidepressants against the symptoms of anhedonia; one such study found that treatment over eight weeks with a melatonin receptor agonist decreased severity scores on depression scales, as well as scores on the Snaith-Hamilton Pleasure Scale that measures anhedonia.⁷ However, effectiveness on symptoms of anhedonia remains an unmet need in the treatment of MDD.^3,6,7

References:

1.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th Edition – Text Revision (DSM-5-TR). © American Psychiatric Association, 2022.

2.Bauer M, Pfennig A, Severus E, et al.; World Federation of Societies of Biological Psychiatry (WFSBP) Task Force on Unipolar Depressive Disorders. WFSBP guidelines for biological treatment of unipolar depressive disorders, part 1: update 2013 on the acute and continuation treatment of unipolar depressive disorders. World J Biol Psychiatry 2013; 14 (5): 334–385.

3.Goodwin GM, Price J, De Bodinat C, Laredo J. Emotional blunting with antidepressant treatments: a survey among depressed patients. J Affect Disord 2017; 221: 31–35.

4.Jawad MY, Fatima M, Hassan U, et al. Can antidepressant use be associated with emotional blunting in a subset of patients with depression? A scoping review of available literature. Hum Psychopharmacol 2023; 38 (4): e2871.

5.Serretti A. Anhedonia and depressive disorders. Clin Psychopharmacol Neurosci 2023; 21 (3): 401–409.

6.Setterfield M, Walsh M, Frey AL, McCabe C. Increased social anhedonia and reduced helping behaviour in young people with high depressive symptomatology. J Affect Disord 2016; 205: 372–377.

7.Gargoloff PD, Corral R, Herbst L, et al. Effectiveness of agomelatine on anhedonia in depressed patients: an outpatient, open-label, real-world study. Hum Psychopharmacol 2016; 31 (6): 412–418.