Black Dog Institute, University of New South Wales, Sydney, NSW, Australia.
McLean Hospital & Harvard Medical School, Belmont, MA, USA.
Mol Psychiatry. 2023 Dec;28(12):5272-5281. doi: 10.1038/s41380-023-02165-1. Epub 2023 Jul 4.
Leading professional health bodies have called for the wider adoption of Patient Reported Outcome Measures, such as quality of life, in research and clinical practice as a means for understanding why the global burden of depression continues to climb despite increased rates of treatment use. Here, we examined whether anhedonia-an often recalcitrant and impairing symptom of depression-along with its neural correlates, was associated with longitudinal changes in patient-reported quality of life among individuals seeking treatment for mood disorders. We recruited 112 participants, including n = 80 individuals with mood disorders (58 unipolar, 22 bipolar) and n = 32 healthy controls (63.4% female). We assessed anhedonia severity along with two electroencephalographic markers of neural reward responsiveness (scalp-level 'Reward Positivity' amplitude and source-localized reward-related activation in the dorsal anterior cingulate cortex), and assessed quality of life at baseline, 3- and 6-month follow-up. Anhedonia emerged as a robust correlate of quality of life cross-sectionally and longitudinally among individuals with mood disorders. Furthermore, increased neural reward responsiveness at baseline was associated with greater improvements in quality of life over time, and this improvement was mediated by longitudinal improvements in anhedonia severity. Finally, differences in quality of life observed between individuals with unipolar and bipolar mood disorders were mediated by differences in anhedonia severity. Our findings indicate that anhedonia and its reward-related neural correlates are linked to variability in quality of life over time in individuals with mood disorders. Treatments capable of improving anhedonia and normalizing brain reward function may be necessary for improving broader health outcomes for individuals seeking treatment for depression.ClinicalTrials.gov identifier: NCT01976975.
主要的专业健康机构呼吁更广泛地采用患者报告的结果测量，如生活质量，以研究和临床实践，作为了解为什么尽管治疗使用率增加，但全球抑郁症负担仍在继续上升的原因。在这里，我们研究了快感缺失——抑郁症的一种常见且难以治疗的症状——及其神经相关性，是否与寻求治疗心境障碍的个体的患者报告生活质量的纵向变化有关。我们招募了 112 名参与者，包括 n=80 名心境障碍患者（58 名单相，22 名双相）和 n=32 名健康对照者（63.4%为女性）。我们评估了快感缺失的严重程度，以及脑电图中两个神经奖励反应的标志物（头皮水平的“奖励正性”幅度和背侧前扣带回皮层的源定位奖励相关激活），并在基线、3 个月和 6 个月时评估了生活质量。快感缺失是心境障碍患者生活质量的横断面和纵向的一个强有力的相关因素。此外，基线时神经奖励反应增加与生活质量随时间的改善有关，而这种改善是通过快感缺失严重程度的纵向改善来介导的。最后，在单相和双相心境障碍患者之间观察到的生活质量差异是由快感缺失严重程度的差异介导的。我们的研究结果表明，快感缺失及其与奖励相关的神经相关性与心境障碍患者随时间变化的生活质量变化有关。能够改善快感缺失和使大脑奖励功能正常化的治疗方法可能对于改善寻求治疗抑郁症的个体的更广泛的健康结果是必要的。ClinicalTrials.gov 标识符：NCT01976975。
