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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We review psychometric and other evidence relevant to mixed anxiety-depression. Properties of anxiety and depression measures, including the convergent and discriminant validity of self- and clinical ratings, and interrater reliability, are examined in patient and normal samples. Results suggest that anxiety and depression can be reliably and validly assessed; moreover, although these disorders share a substantial component of general affective distress, they can be differentiated on the basis of factors specific to each syndrome. We also review evidence for these specific factors, examining the influence of context and scale content on ratings, factor analytic studies, and the role of low positive affect in depression. With these data, we argue for a tripartite structure consisting of general distress, physiological hyperarousal (specific anxiety), and anhedonia (specific depression), and we propose a diagnosis of mixed anxiety-depression.
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PMID:Tripartite model of anxiety and depression: psychometric evidence and taxonomic implications. 191 11

Seventeen patients with Parkinson's disease which was markedly asymmetric and worse on the right side of the body (RHP) were compared with 13 patients whose signs were worse on the left (LHP). The two groups of patients were well matched for age, duration of symptoms, disability, overall severity of signs, and medication. The mean scores on ratings of depression, using both a self-rating scale and semi-structured interview rating, were almost twice as great in the LHP group. The LHP group also had significantly more symptoms of anxiety. The prevalence of clinically significant psychopathology was increased about five fold in the LHP group compared with the RHP group. There was a close correlation between anxiety and depressive symptoms. The depression experienced by the patients was 'atypical', with relatively little anhedonia and evidence of a negative view of self, and prominent symptoms of anxiety. The best predictor of symptoms of depression and anxiety was a measure of social support and stress. They also correlated with the overall severity of Parkinson's disease.
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PMID:Left-sided Parkinson's disease is associated with greater anxiety and depression. 194 51

It has been suggested that uncontrollable stressors induce motivational changes in animals which are reminiscent of reward alteration in human depression. Although there is considerable support for this position, most animal models of depression do not adequately address this issue. The present review suggests that stressor-induced reductions in the rewarding value of electrical brain stimulation (ICSS) from the mesocorticolimbic system may simulate the anhedonia of human depression. The magnitude, severity and the site of these stressor-induced reward alterations within the mesocorticolimbic system vary with the strain of animal employed. The anhedonic effects of stressors are attenuated by treatments which influence mesocorticolimbic DA turnover, including systemic antidepressant and intraventricular neuropeptide administration. Although the diverse symptom profile of depression should be addressed by consideration of the constellation of behavioral disturbances induced by stressors, considerable emphasis should be devoted to an assessment of reward loss in depression. The implications of these data to the stressor depression topography and the potential role of mesocorticolimbic DA in depression and anhedonia are discussed.
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PMID:Stressor-induced anhedonia in the mesocorticolimbic system. 195 7

Cocaine use frequently occurs in episodic, prolonged binges. Following such a cocaine binge, the user suffers from severe depressive symptoms mixed with irritability and anxiety ("crash"). The present study was an attempt to develop an animal model of postcocaine depression or anhedonia and to study the time course of this cocaine withdrawal symptom. Rats were allowed to self-administer cocaine intravenously for prolonged periods of time and their brain reward thresholds were then assessed using intracranial self-stimulation (ICSS) thresholds. ICSS thresholds were used operationally as a measure of the animals' "hedonic-anhedonic" state. It was found that during cocaine withdrawal ICSS thresholds were elevated compared to predrug baseline levels and to control animals' thresholds, reflecting an "anhedonic" state. The magnitude and duration of the "anhedonic" state was proportional to the amount of cocaine consumed during the binge. A measure of response latency provided evidence that this postcocaine elevation of thresholds is due to a desensitization of the reward pathways mediating ICSS reward and not to any nonspecific (e.g., performance) effects of the cocaine exposure.
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PMID:Postcocaine anhedonia. An animal model of cocaine withdrawal. 2654 64

The symptom of anhedonia, or loss of pleasure, is widely recognized to occur in depression. More recently it has been suggested that this symptom alone might be the basis for a diagnosis of depression in medically ill patients, and the Hospital Anxiety and Depression Scale (HAD) has been designed with this in mind. To test the hypothesis that this symptom might discriminate well between major depressive disorder and other mental disorders, this study measured the degree and incidence of anhedonia in 147 consecutive psychiatric outpatients with a variety of DSM-III-R diagnoses. Anhedonia was assessed using items from the HAD. The results showed that, although depressed patients scored highly for anhedonia, this symptom was present in the majority of patients with diagnoses other than major depressive illness. Thus this symptom alone was unable to clearly distinguish between mental disorders, and it may therefore be inappropriate to use anhedonia as the basis for a diagnostic measure.
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PMID:Is anhedonia a good measure of depression? 202

In the search for a valid analysis of a number of operationalised symptoms common to depressive behaviour, a study was performed comprising 46 patients showing depressive symptoms, according to operationalised criteria and as part of which all agreed to undergo the following tests: (a) psychiatric: Present State Examination; (b) psychological: Hamilton Rating Scale, Montgomery-Asberg Rating Scale, State-Trait Anxiety Inventory, Beck Suicide Ideation Scale, Chapman Anhedonia Scale, Mood Scale, Sleep Quality Scale, Activities Scale, Social Support Scale, Questionnaire on Recently Experienced Events and the Paykel Life Events Interview; and (c) biochemical: Dexamethasone Suppression (DEX) Test. After gathering different depressive subgroups, based on operationalised symptoms, a dichotomy was made in the distributions of the (an)hedonia, suicide ideation and DEX-(non) suppression scores. This study may indicate that anhedonia, suicide ideation and DEX-nonsuppression are the opening to the identification of a subgroup of depressed patients. This symptom complex could not definitely be identified on the basis of existing DSM-III diagnostic entities, because of the known fact that this method of classification is not appropriate for our purposes in revealing pathophysiological processes. It is suggested, therefore, that these symptoms might prove to be the anchor-point from which to reach a better insight into the aetiology and pathogenesis (i.e. the final common pathway) of depression.
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PMID:Anhedonia, suicide ideation and dexamethasone nonsuppression in depressed patients. 236 12

In depression studies, it is important to consider healthy subjects with characteristics which may be predictive of depression. Such are anhedonia and some "dysfunctional" attitudes. For this reason, subjects with or without these characteristics were submitted to an experimental paradigm allowing an analysis of their electroencephalographical (CNV and P300) reactivity according to affective value and meaning of stimuli, and according to the probability of occurrence of these stimuli. Subjects were divided into two groups according to their scores on two scales: the Physical Anhedonia Scale of Chapman et al. and the Dysfunctional Attitudes Scale of Weissman and Beck. Several results enabled to differentiate the two groups. Anhedonic and depressogenic subjects were characterized mainly by a particular type of processing for failure situations and for the stimulus which were associated with those situations.
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PMID:[Study of cognitive evoked potentials as a function of the affective value and significance of stimuli in anhedonic healthy subjects with dysfunctional attitudes]. 238 43

Anhedonia, the loss of the capacity of feeling pleasure, was first introduced at the end of the last century by a French psychologist, Ribot, and has been the object of much research, essentially in English, for the last decades, in schizophrenia, in depression, in schizoid disorders. After considering the problems of quantitative evaluation, we review the literature and conclude that anhedonia appears to be a multi-morphological symptom and the are probably several types of anhedonia, which shows the necessity of developing more specific reliable evaluation instruments and of diversifying the approaches. We show the utility, in particular, of a psychophysiological approach using endogenous Evoked Potentials. Then several research directions in psychiatry are discussed: what place has anhedonia in the negative form of schizophrenia? Does anhedonia constitute a specific marker of certain endogenous depressions? Does it constitute a personality trait that predisposes to morbidity?
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PMID:[Anhedonia in psychiatry: a review]. 269 84

This article focuses on the measurement of 'negative symptoms'. Standardized scales used to rate negative symptoms are reviewed and compared, as are the individual items which comprise them. The overlap of negative symptoms, akinesia, and depression is explored, and means are suggested to improve the precision of defining and measuring negative symptoms. Flat affect is the only item present in all negative symptom scales and may overlap with depression and akinesia. Inappropriate affect and attentional disturbance should not be considered negative symptoms. Poverty of speech and anhedonia lack unified definitions, and in some scales, they can also be confounded with depression and akinesia. The psychometric properties of most scales have not been sufficiently studied. The lack of long-term studies of stability of the supposedly enduring negative symptoms is especially worrisome. Carpenter's deficit syndrome consisting of non-secondary negative symptoms lasting more than one year is a promising new step to try and address some of these problems.
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PMID:Measurement of negative symptoms in schizophrenia. 270 Aug 1

The Pleasure Scale for Children, a measure developed to assess anhedonia in school-age children, was evaluated. Psychometric properties and concurrent validity of the scale were evaluated with 232 child psychiatric inpatient children (ages 6-13) and their parents. Based on prior research with adults, predictions were made that children with a diagnosis of major depression would evince greater anhedonia on the scale and that anhedonic children (low Pleasure Scale scores) would show a negative attributional style in relation to rewarding experiences. The results indicated that the Pleasure Scale was internally consistent, yielded moderate to high item-total score correlations, appeared to reflect a single dimension, and correlated positively and significantly with other measures of pleasurable affect. Depressed children showed greater anhedonia, as reflected in lower total Pleasure Scale scores and in their pattern of responding to individual items on the scale. Children high in anhedonia, independently of their diagnosis, showed less active involvement in seeking rewards, were higher in their expectations of negative outcomes, and were more likely to attribute unrewarding outcomes to their own behavior than to external causes. Overall, the results provide initial support for the construct validity of the scale. Further research to evaluate nonclinic samples, to develop alternative assessment strategies, to examine developmental differences in reporting pleasurable experiences, and to study the relation of anhedonia to subtypes and clinical course of depression is briefly discussed.
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PMID:Evaluation of the Pleasure Scale in the assessment of anhedonia in children. 273 2


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