Kasahara-Kiritani Mami, Kato Tadafumi, Wakamatsu Akihide, Webb Thomas, Herr Keira, Vandervoort Lawrence, Li Nan
Integrated Market Access Division, Johnson & Johnson, Tokyo, Japan.
Department of Psychiatry and Behavioral Science, Juntendo University Graduate School of Medicine, Tokyo, Japan.
BMC Psychiatry. 2025 Jul 1;25(1):631. doi: 10.1186/s12888-025-07089-4.
Anhedonia (ANH), one of the core symptoms of major depressive disorder (MDD), poses a significant health challenge. We evaluated the prevalence of ANH among MDD patients in Japan, and elucidated patient journey from patients' and physicians' perspective.
This cross-sectional observational study (April-May 2023) utilized a self-reported, online-based survey targeting the general population (non-physicians) and physicians. The general population (aged ≥ 18 years) were screened for MDD using Patient Health Questionnaire-9 (PHQ-9 ≥ 10); MDD patients were further screened for ANH using Snaith-Hamilton Pleasure Scale (SHAPS; MDD-ANH: SHAPS > 2, MDD non-ANH: SHAPS ≤ 2). The age- and gender-weighted prevalences of MDD and MDD-ANH, patient journey, and treatment goals and satisfaction between patients and physicians were reported. P-value < 0.05 was considered statistically significant.
The prevalence of MDD was 3.4% (n = 514; N = 15,266) and the prevalence of ANH in MDD was 66.9% (n = 344). Mean (± standard deviation) age of MDD-ANH patients (n = 282) was 46.1 ± 12.5 years, while for MDD non-ANH patients (n = 50) was 49.6 ± 8.5 years. Physicians (n = 60) had mean 21.9 years of experience working as psychiatrists. Physicians reported that 33.9% of their MDD patients had anhedonia. MDD-ANH patients scored significantly higher (p < 0.05) than MDD non-ANH patients on all PHQ-9 items, except for feeling tired/having little energy and poor appetite/overeating. A higher percentage of MDD-ANH patients reported current prescription use for depression than MDD non-ANH patients (67.0% vs. 51.3%; p = 0.0677). Treatment duration with multiple prescriptions was significantly longer in MDD-ANH than MDD non-ANH patients (102.1 ± 89.8 vs. 53.8 ± 33.7 months; p = 0.0035). The majority of physicians (90.0%) reported that they do not focus on treating anhedonia separately from MDD. Patients with MDD-ANH perceived "reduce psychological anxiety", "control depressed mood", and "improve sleep quality" as more important treatment goals, compared to physicians' importance to avoid suicidal thoughts, restore normal social function, and regain interest in hobbies. Treatment satisfaction levels were higher among physicians than MDD-ANH patients across all treatment goals.
This study in Japan reported high prevalence of ANH among MDD patients which was significantly underestimated by physicians. Discordances in treatment goals and satisfaction were observed between physicians and MDD patients, highlighting the need for aligning patient and physician expectations.
Not applicable.
快感缺失（ANH）是重度抑郁症（MDD）的核心症状之一，对健康构成重大挑战。我们评估了日本MDD患者中快感缺失的患病率，并从患者和医生的角度阐明了患者就医过程。
这项横断面观察性研究（2023年4月至5月）采用了针对普通人群（非医生）和医生的基于网络的自我报告调查。使用患者健康问卷-9（PHQ-9≥10）对普通人群（年龄≥18岁）进行MDD筛查；使用斯奈斯-汉密尔顿快感量表（SHAPS；MDD-ANH：SHAPS>2，MDD非ANH：SHAPS≤2）对MDD患者进一步进行快感缺失筛查。报告了MDD和MDD-ANH的年龄和性别加权患病率、患者就医过程以及患者与医生之间的治疗目标和满意度。P值<0.05被认为具有统计学意义。
MDD的患病率为3.4%（n=514；N=15266），MDD中快感缺失的患病率为66.9%（n=344）。MDD-ANH患者（n=282）的平均（±标准差）年龄为46.1±12.5岁，而MDD非ANH患者（n=50）为49.6±8.5岁。医生（n=60）的精神科工作平均经验为21.9年。医生报告称，他们的MDD患者中有33.9%存在快感缺失。除了感到疲倦/精力不足和食欲不佳/暴饮暴食外，MDD-ANH患者在所有PHQ-9项目上的得分均显著高于（p<0.05）MDD非ANH患者。与MDD非ANH患者相比，MDD-ANH患者中报告目前正在使用抗抑郁药物治疗的比例更高（67.0%对51.3%；p=0.0677）。MDD-ANH患者使用多种药物的治疗持续时间显著长于MDD非ANH患者（102.1±89.8对53.8±33.7个月；p=0.0035）。大多数医生（90.0%）报告称，他们没有将快感缺失与MDD分开进行治疗。与医生认为避免自杀念头、恢复正常社会功能和重新获得对爱好的兴趣更为重要相比，MDD-ANH患者认为“减轻心理焦虑”、“控制抑郁情绪”和“改善睡眠质量”是更重要的治疗目标。在所有治疗目标中，医生的治疗满意度高于MDD-ANH患者。
日本的这项研究报告称，MDD患者中快感缺失的患病率很高，而医生对此的估计明显偏低。观察到医生与MDD患者在治疗目标和满意度方面存在差异，突出了使患者和医生期望一致的必要性。
不适用。
