TITLE:
Anhedonia and Reward System: Psychobiology, Evaluation, and Clinical Features
AUTHORS:
Giovanni Martinotti, Daniele S. Hatzigiakoumis, Ofelia De Vita, Massimo Clerici, Filippo Petruccelli, Massimo Di Giannantonio, Luigi Janiri
KEYWORDS:
Anhedonia; Pleasure; Dopaminergic Reward System; Substance Dependence; SHAPS; CPAS; SAS; FCPS; SANS; BRMES; VAS; TEPS
JOURNAL NAME:
International Journal of Clinical Medicine,
Vol.3 No.7,
January
2,
2013
ABSTRACT: Anhedonia can be defined as a condition in which the hedonic
capacity is totally or partially lost. From a psychobiological perspective,
several researchers proposed that anhedonia has a putative neural substrate,
the dopaminergic mesolimbic and mesocortical reward circuit, which involves the
ventral tegmental area, the ventral striatum and part of the prefrontal cortex.
Anhedonia is, besides depressed mood, one of the two core symptoms of
depression; furthermore it is one of the most important negative symptom in
schizophrenia. Anhedonia is also present in substance use disorders as part of
the abstinence symptomatology, and interrelations between hedonic capability,
craving and protracted withdrawal have been found, particularly in
opiate-dependent subjects. Although anhedonia is regarded as an important
symptom in psychopathology, so far it has received relatively little attention.
In general, two main approaches have been utilized to investigate and assess
anhedonia or hedonic capacity: laboratory-based measures and questionnaires.
Among measurement scales, the most commonly used are the Snaith-Hamilton
Pleasure Scale (SHAPS), the Fawcett-Clark Pleasure Scale (FCPS), and the
Revised Chapman Physical Anhedonia Scale (CPAS). Nevertheless, other
measurement scales, particularly used within broader psychopathological
dimensions, are the Anhedonia-Asociality subscale (SANSanh) of the Scale for
the Assessment of Negative Symptoms (SANS) and the Bech-Rafaelsen Melancholia
Scale (BRMS). In this paper we analyze these different scales, individuating
their strengths and limits and their current clinical applications.