National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA.
Transl Psychiatry. 2020 Aug 7;10(1):273. doi: 10.1038/s41398-020-00960-w.
Fatigue and anhedonia are commonly reported, co-occurring clinical symptoms associated with chronic illnesses. Fatigue is a multidimensional construct that is defined as a distressing, persistent, subjective sense of physical, cognitive, or emotional tiredness that interferes with usual functioning. Anhedonia is a component of depressive disorders and other psychiatric conditions, such as schizophrenia, and is defined by the reduced ability to experience pleasure. Both symptoms greatly affect the health-related quality of life of patients with chronic illnesses. Although fatigue and anhedonia are commonly associated with each other, understanding the differences between the two constructs is necessary for diagnosis and clinical treatment. A scoping review was conducted based on published guidance, starting with a comprehensive search of existing literature to understand the similarities and differences between fatigue and anhedonia. An initial search of PubMed using fatigue and anhedonia as medical subject headings yielded a total of 5254 articles. A complete full-text review of the final 21 articles was conducted to find articles that treated both constructs similarly and articles that presented fatigue and anhedonia as distinct constructs. About 60% of the reviewed articles consider both constructs as distinct, but a considerable number of the reviewed articles found these constructs indistinguishable. Nomenclature and biology were two themes from the reviewed articles supporting the idea that anhedonia and fatigue are indistinguishable constructs. The information generated from this review is clinically relevant to optimize the management of fatigue related to anhedonia from other fatigue subtypes.
疲劳和快感缺失是常见的与慢性疾病相关的共病临床症状。疲劳是一种多维结构，定义为一种令人痛苦、持续、主观的身体、认知或情绪疲劳感，会干扰正常功能。快感缺失是抑郁症和其他精神疾病（如精神分裂症）的一个组成部分，其特征是体验愉悦的能力降低。这两种症状都会极大地影响慢性疾病患者的健康相关生活质量。尽管疲劳和快感缺失通常是相互关联的，但了解这两种结构之间的区别对于诊断和临床治疗是必要的。根据已发表的指南进行了范围综述，从全面搜索现有文献开始，以了解疲劳和快感缺失之间的相似之处和区别。最初使用疲劳和快感缺失作为医学主题词在 PubMed 上进行搜索，共产生了 5254 篇文章。对最终 21 篇文章进行了完整的全文审查，以找到将这两种结构视为相似的文章和将疲劳和快感缺失视为不同结构的文章。约 60%的综述文章认为这两种结构是不同的，但相当数量的综述文章发现这两种结构难以区分。从综述文章中可以看出，命名法和生物学是支持快感缺失和疲劳是不可区分的结构的两个主题。从这项综述中获得的信息对优化与其他疲劳亚型相关的快感缺失引起的疲劳的管理具有临床意义。
