Siwek Marcin, Chrobak Adrian A, Sołtys Zbigniew, Dudek Dominika, Krupa Anna J
Department of Affective Disorders, Jagiellonian University Medical College, Kopernika St. 21a, 31-501 Krakow, Poland.
Department of Adult Psychiatry, Jagiellonian University Medical College, Kopernika St. 21a, 31-501 Krakow, Poland.
Brain Sci. 2024 Aug 31;14(9):890. doi: 10.3390/brainsci14090890.
Anhedonia constitutes a core symptom of major depressive disorder (MDD) mediating the ultimate goal of MDD treatment: functional remission. Anhedonia is also present in other clinical populations, including patients with chronic pain. Recent data links anhedonia to insulin resistance (IR). Some researchers have underlined a different dimension of anhedonia as a temperament/personality trait. The objective of this post-hoc analysis was to explore the links between anhedonia (main outcome) and (1) IR, (2) temperamental, personality, and schizotypy traits (exposures). The study population included patients with MDD, fibromyalgia, and healthy controls. Participants were split into groups: (1) insulin resistant (IR[+] = 69, HOMA-IR ≥ 2.1) and (2) insulin sensitive (IR[-] = 69, HOMA-IR < 2.1). Anhedonia was significantly higher in the IR[+] group than the IR[-] group. IR was a predictor of higher anhedonia levels. IR[+] vs. IR[-] participants showed higher levels of anxiety and lower levels of hyperthymic affective temperaments, as well as conscientiousness and emotional stability personality traits. Depressive, irritable, and anxious temperaments, cognitive disorganization, and introvertive anhedonia positively predicted anhedonia, while hyperthymic temperament, conscientiousness, extraversion, and emotional stability traits negatively predicted anhedonia. IR partially mediated the relationship between depressive temperament and anhedonia. In sum, IR, affective temperaments, and personality traits are predictors of anhedonia.
快感缺失是重度抑郁症(MDD)的核心症状,介导着MDD治疗的最终目标:功能缓解。快感缺失也存在于其他临床人群中,包括慢性疼痛患者。最近的数据将快感缺失与胰岛素抵抗(IR)联系起来。一些研究人员强调了快感缺失作为一种气质/人格特质的不同维度。这项事后分析的目的是探讨快感缺失(主要结果)与(1)IR、(2)气质、人格和分裂型特质(暴露因素)之间的联系。研究人群包括MDD患者、纤维肌痛患者和健康对照者。参与者被分为两组:(1)胰岛素抵抗组(IR[+]=69,HOMA-IR≥2.1)和(2)胰岛素敏感组(IR[-]=69,HOMA-IR<2.1)。IR[+]组的快感缺失显著高于IR[-]组。IR是快感缺失水平较高的一个预测因素。与IR[-]参与者相比,IR[+]参与者表现出更高水平的焦虑和更低水平的高胸腺情感气质,以及尽责性和情绪稳定性人格特质。抑郁、易怒和焦虑气质、认知紊乱以及内向性快感缺失正向预测快感缺失,而高胸腺气质、尽责性、外向性和情绪稳定性特质负向预测快感缺失。IR部分介导了抑郁气质与快感缺失之间的关系。总之,IR、情感气质和人格特质是快感缺失的预测因素。