Anhedonia in endometriosis: An unexplored symptom

Abstract

Anhedonia is the diminished motivation and sensitivity to pleasurable stimuli. It has been reported to be more prevalent in patients with chronic pain as compared to healthy controls. Endometriosis is a chronic inflammatory systemic disease with a significant psychosocial impact that compromises wellbeing and the day-to-day life of patients. Women with endometriosis show significant psychological distress, even more pervasive when chronic pelvic pain is present. In the current review we will discuss the role of anhedonia in endometriotic chronic pelvic pain. We will also present new lines of research that could lead to more fully clarifying the psychological impact of endometriosis and its detrimental repercussions to quality of life and mental health.

The presence of anhedonia in individuals with subacute and chronic stroke: an exploratory cohort study

“…These results are in line with a recent previous study suggesting the role of anhedonia as a predictor of somatic symptoms of depression, such as fatigue, over the first year after discharge from rehabilitation (Ashaie et al, 2023). Our findings also underlines the likely role of anhedonia in generating a deteriorating looping effect at a behavioral level (Mallorqui et al, 2022). Additionally, older patients in the chronic group exhibited higher levels of anhedonia, consistent with previous research suggesting that the ageing brain is more sensitive to neurodegeneration mechanisms (Yan et al, 2010;Li et al, 2020;Stuckey et al, 2021).…”

“…Importantly, studies on chronic pain and other inflammatory conditions have observed similar results ( Lucido et al, 2021 ). For example, Garland et al (2020) reported that nearly 25% of chronic pain patients exhibited higher anhedonia levels, which is in line with previous research demonstrating higher anhedonia levels in women suffering endometric chronic pelvic pain ( Mallorqui et al, 2022 ). Additionally, a recent review revealed the relationship of acute and chronic stress with increased peripheral and central inflammation and consequent dysregulation of the reward system, leading to the onset or development of anhedonia ( Boyle et al, 2023 ).…”

“…Hence, the chronic low-grade endogenous inflammation could continuously shape the pathology following stroke, promoting the ongoing impairment of the mesolimbic pathway in the long term regardless of lesion location, stroke etiology, and time since stroke ( Shi et al, 2019 ; Stuckey et al, 2021 ). Additionally, these impairments in top-down cognitive-behavioral processes could alienate patients from natural and previously acquired resources of pleasure and positive experiences, potentially contributing to anhedonia development even years after stroke ( Mallorqui et al, 2022 ).…”

“…Hence, the chronic low-grade endogenous inflammation could continuously shape the pathology following stroke, promoting the ongoing impairment of the mesolimbic pathway in the long term regardless of lesion location, stroke etiology, and time since stroke (Shi et al, 2019;Stuckey et al, 2021). Additionally, these impairments in top-down cognitive-behavioral processes could alienate patients Segura et al 10.3389/fnagi.2024.1253028 Frontiers in Aging Neuroscience 11 frontiersin.org from natural and previously acquired resources of pleasure and positive experiences, potentially contributing to anhedonia development even years after stroke (Mallorqui et al, 2022). Individuals with anhedonia are characterized by enjoying less of things in life by themselves and with others, which triggers a lack of interest in engaging in rewarding activities and participating in community life in the long term (Kusec et al, 2019).…”

“…Interestingly, this result was not entirely motivated by a comorbid depression diagnosis, pointing out a more nuanced perspective of the psychological consequences of some health conditions. Furthermore, a recent review on endometriosis, a gynecological chronic systemic inflammatory disease characterized by the presence of chronic pelvic pain, presented anhedonia as a severe symptom which is not assessed in the usual clinical treatment despite the deleterious consequences in patients’ mental health and quality of life (QoL) ( Mallorqui et al, 2022 ).…”