Brain-Behaviour Research Group, University of New England, New South Wales, 4225, Australia.
Psychooncology. 2013 Aug;22(8):1718-23. doi: 10.1002/pon.3203. Epub 2012 Sep 27.
This study aimed to compare the prevalence of depressed mood and anhedonia in a sample of men with prostate cancer (PCa) and to determine which of these key symptoms contributed most to the overall depressive status of that sample.
From Zung Self-rating Depression Scale (SDS) responses collected on 526 PCa patients, direct comparisons were made between the prevalence of the first two DSM-IV-TR symptoms of Major Depressive Episode. These symptoms were then tested for their predictive power on depression total score and Zung's criteria for 'clinically significant' depression.
Mean scores for anhedonia were significantly higher than for depressed mood, and nearly 25 times as many patients had a high score for anhedonia as for depressed mood. The same pattern of results was apparent for those patients who had clinically significant levels of depression. Anhedonia was a more powerful predictor of total SDS depression score for the entire sample as well as for those patients with more severe depression.
Because the biological basis for anhedonia is different to that for depressed mood, treatment options also differ for patients who show a preponderance of anhedonia in their depressive symptomatology. Suggestions are made for treatment choices for these PCa patients.
本研究旨在比较前列腺癌（PCa）患者样本中抑郁情绪和快感缺失的患病率，并确定这些关键症状中哪一个对该样本的总体抑郁状况贡献最大。
从 526 名 PCa 患者的 Zung 自评抑郁量表（SDS）反应中，直接比较了主要抑郁发作的前两个 DSM-IV-TR 症状的患病率。然后，测试了这些症状对抑郁总分和 Zung 的“临床显著”抑郁标准的预测能力。
快感缺失的平均得分明显高于抑郁情绪，而且有快感缺失高分的患者几乎是抑郁情绪高分患者的 25 倍。对于那些有临床显著水平抑郁的患者，同样的结果模式是明显的。快感缺失是整个样本以及那些抑郁程度更严重的患者 SDS 抑郁总分的更有力预测指标。
由于快感缺失的生物学基础与抑郁情绪不同，因此对于表现出抑郁症状中快感缺失占优势的患者，治疗选择也不同。为这些 PCa 患者提出了治疗选择建议。
