Imperial College London, London, UK.
J Psychopharmacol. 2013 Oct;27(10):869-77. doi: 10.1177/0269881113494104. Epub 2013 Jul 31.
It is 16 years since we reviewed anhedonia in depression. Since then, there have been important developments in the study of anhedonia, mainly using the new techniques that neuroimaging made available, which provide very interesting new insights. It is becoming increasingly apparent that anhedonia, with psychomotor retardation, defines a dimension in depressive disorder that seems to be distinct from a dimension encompassing mood plus somatic symptoms. These dimensions can coexist, but may also be present separately. The first appears associated with disturbances (under-functioning) in dopamine function; the other appears to be related to a similar under-functioning in the serotonin system. Furthermore, anhedonia itself increasingly appears to be a composite symptom, consisting of at least two dimensions (i.e. a motivational/appetitive and a consummatory one). Depression appears to be characteristically linked more to the first one, in contrast to what was originally thought. We discuss the significance of the above in the evolving treatment of depression and the potential use of dopamine-targeting drugs.
距我们上次综述抑郁障碍中的快感缺失已有 16 年。自那时起，快感缺失的研究取得了重要进展，主要得益于神经影像学提供的新技术，这些技术为我们带来了非常有趣的新见解。快感缺失伴有精神运动迟滞，将抑郁障碍定义为一个维度，这一点变得越来越明显，它似乎与包含心境和躯体症状的另一个维度不同。这两个维度可以同时存在，但也可能单独存在。前者似乎与多巴胺功能障碍（功能不足）有关；后者似乎与 5-羟色胺系统的类似功能不足有关。此外，快感缺失本身似乎越来越成为一个复合症状，至少由两个维度组成（即动机/欲望和满足）。与最初的想法相反，抑郁似乎与前者关系更密切。我们讨论了上述发现对不断发展的抑郁障碍治疗以及多巴胺靶向药物潜在用途的意义。
