Horan William P, Kring Ann M, Blanchard Jack J
University of California, Los Angeles, USA.
Schizophr Bull. 2006 Apr;32(2):259-73. doi: 10.1093/schbul/sbj009. Epub 2005 Oct 12.
Anhedonia, the diminished capacity to experience pleasant emotions, is a common, treatment-resistant feature of schizophrenia that is often included among the negative symptoms of this disorder. This selective review describes the 3 most commonly used approaches to assess anhedonia in schizophrenia: interview-based measures, self-report trait questionnaires, and laboratory-based assessments of emotional experience. For each assessment approach, psychometric properties, relationships to other symptoms and features of schizophrenia, and relationships with the other assessment approaches are evaluated. It is concluded that anhedonia can be reliably assessed and constitutes a distinctive, clinically important aspect of schizophrenia that should be included in a comprehensive evaluation of negative symptoms. Current efforts to define more precisely the nature of the hedonic deficit in schizophrenia are discussed, and recommendations for optimal assessment of anhedonia in clinical trials of novel treatments for negative symptoms are provided.
快感缺失,即体验愉悦情绪的能力下降,是精神分裂症常见且难治的特征,常被纳入该疾病的阴性症状之中。这篇选择性综述描述了评估精神分裂症快感缺失的3种最常用方法:基于访谈的测量、自我报告特质问卷以及基于实验室的情绪体验评估。对于每种评估方法,都评估了其心理测量特性、与精神分裂症其他症状及特征的关系以及与其他评估方法的关系。得出的结论是,快感缺失能够得到可靠评估,并且构成了精神分裂症一个独特的、具有临床重要性的方面,应纳入阴性症状的全面评估之中。文中讨论了当前为更精确界定精神分裂症享乐缺陷本质所做的努力,并针对阴性症状新型治疗方法的临床试验中快感缺失的最佳评估提供了建议。