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Chapter 19 - Did We Lose Interest and Pleasure in the Concept of Major Depression?

Published online by Cambridge University Press:  01 February 2024

Andrea Fiorillo
Affiliation:
University of Campania “L. Vanvitelli”, Naples
Peter Falkai
Affiliation:
Ludwig-Maximilians-Universität München
Philip Gorwood
Affiliation:
Sainte-Anne Hospital, Paris
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Summary

human beings generally experience a positive mood, while depressed patients have an excess in negative mood and a deficit in positive mood. Lack of positive affect and anhedonia (lack of interest and pleasure) are probably the most specific depressive symptoms, differentiating depression from other psychopathological states. Recently, there has been increased interest in their importance in depressive disorders. This chapter focuses on a detailed content analysis of positive affect and hedonic tone. The specific importance of a lack of positive affect and of anhedonia is described: they are linked to longevity in healthy as well as in medically ill persons, they are linked to suicidality, they are central in depressed patient expectations, and their early changes during treatment are strong predictors of treatment outcome. Despite anhedonia being a core DSM symptom in major depression, standard depression rating scales take insufficient account of anhedonia; thus, several newer anhedonia scales were developed more recently. Finally, the effect of psychopharmacological and psychotherapeutic treatments on positive affect and on anhedonia are discussed.

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Chapter
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Mental Health Research and Practice
From Evidence to Experience
, pp. 341 - 354
Publisher: Cambridge University Press
Print publication year: 2024

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