McLean Hospital & Harvard Medical School, USA.
J Psychiatr Res. 2013 Dec;47(12):1864-9. doi: 10.1016/j.jpsychires.2013.08.011. Epub 2013 Sep 8.
Major depressive disorder has been associated with blunted responsiveness to rewards, but inconsistencies exist whether such abnormalities persist after complete remission. To address this issue, across two independent studies, 47 adults with remitted major depressive disorder (rMDD) and 37 healthy controls completed a Probabilistic Reward Task, which used a differential reinforcement schedule of social or monetary feedback to examine reward responsiveness (i.e., ability to modulate behavior as a function of reinforcement history). Relative to controls, adults with rMDD showed blunted reward responsiveness. Importantly, a history of depression predicted reduced reward learning above and beyond residual depressive (including anhedonic) symptoms and perceived stress. Findings indicate that blunted reward responsiveness endures even when adults are in remission and might be a trait-related abnormality in MDD. More research is warranted to investigate if blunted reward responsiveness may predict future depressive episodes and whether targeting reward-related deficits may prevent the re-occurrence of the disorder.
重度抑郁症与对奖励的反应迟钝有关，但在完全缓解后，这种异常是否持续存在存在不一致。为了解决这个问题，在两项独立的研究中，47 名缓解期的重度抑郁症（rMDD）患者和 37 名健康对照者完成了一项概率奖励任务，该任务使用社会或金钱反馈的差异强化时间表来检查奖励反应（即根据强化历史调整行为的能力）。与对照组相比，rMDD 患者的奖励反应迟钝。重要的是，抑郁史预测了在残留的抑郁（包括快感缺失）症状和感知压力之外的，奖励学习的减少。研究结果表明，即使在成年人缓解期，奖励反应迟钝仍然存在，这可能是 MDD 的一种与特质相关的异常。需要进一步的研究来调查奖励反应迟钝是否可以预测未来的抑郁发作，以及针对奖励相关缺陷是否可以防止疾病的再次发生。
