Association between anhedonia severity and clinical, humanistic, and economic outcomes among US adults with major depressive disorder.

BACKGROUND

Anhedonia is a key symptom and part of the diagnostic criterion of major depressive disorder (MDD). However, the relationship between anhedonia severity and the clinical, humanistic, and economic burden among patients with MDD is poorly understood.

METHODS

Adults diagnosed with depression were identified from the 2022 US National Health and Wellness Survey (NHWS). Participants with depression were recontacted to participate in an online cross-sectional survey to collect data on anhedonia, using the Snaith-Hamilton Pleasure Scale (SHAPS). Multivariable analyses assessed the association of SHAPS score with health-related outcomes, while controlling for age, sex, race, comorbidity burden, and insurance status. The SHAPS (score range: 14 to 56) assesses the ability to experience pleasure, with higher scores indicating greater levels of anhedonia.

RESULTS

Of the 8,270 NHWS respondents with depression who met inclusion criteria, 665 completed the recontact survey (mean age, 58.4 years; female, 78.3%). Mean SHAPS score was 25.4 (range, 14-47). After adjustments for covariates, higher SHAPS scores were significantly (all p <0.05) associated with higher levels of depression (β = 0.211) and anxiety (β = 0.126), poorer mental (β = -0.339) and physical health-related quality of life (β = -0.178), greater impairment while working [Rate Ratio (RR) = 1.02], and higher direct medical costs (RR = 1.02).

CONCLUSIONS

In adults with depression, higher levels of anhedonia were associated with greater clinical, humanistic, and economic burden. These results highlight the need for targeted treatments to help patients with MDD with prominent anhedonia attain improved clinical, humanistic, and work productivity outcomes.