Association between anhedonia and suicidal events in patients with mood disorders: A 3‐year prospective study

Abstract

Background: As almost all mental disorders are associated with increased suicidalrelated behavior, anhedonia might be a trans-diagnostic dimension to target for suicide prevention. Methods: For this 3-year-long prospective study, 2,839 outpatients with mood disorders were recruited. They were divided in: (a) two groups according to the occurrence or not of suicidal ideation during the follow-up, and (b) two groups according to the occurrence or not of suicide attempts during the follow-up. Anhedonia was assessed using a composite score (the French version of the 14-item Snaith-Hamilton Pleasure Scale and item 13 of the Quick Inventory of Depressive Symptomatology scale) at inclusion and at 6, 12, 24, and 36 months after inclusion. Results: Patients with mood disorders and anhedonia at least at one follow-up visit had a 1.4-fold higher risk of suicidal ideation (adjusted odds ratio = 1.35; 95% confidence interval [1.07, 1.70]), even after adjustment for confounding factors of suicide risk (i.e., bipolar or unipolar disorder, sex, age, marital status, education level, antidepressant intake, personal history of suicide attempt, at least one childhood trauma, and mean of the maximum depression score during the follow-up). Conversely, association between anhedonia and suicide attempt did not remain significant after adjustment. Conclusions: The significant association between anhedonia and suicide ideation in patients with mood disorders stresses the need of targeting hedonia in mood disorders, and of research focusing on the position to pleasure in life through eudaimonia.

Aiding and Abetting Anhedonia: Impact of Inflammation on the Brain and Pharmacological Implications

“…Indeed, data for a role of inflammation in schizophrenia and bipolar disorder are similar to those seen in depression (Goldstein et al, 2009;Najjar and Pearlman, 2015). Moreover, suicide has been linked with inflammation, possibly through its association with anhedonia (Ducasse et al, 2020).…”

“…Thus, inflammatory states that in ancestral times may have promoted survival can become chronic and unremitting, leading to behavioral changes that serve as a pathophysiological substrate for shifts in reward processing that ultimately aid and abet anhedonia, a core symptom of depression that is also well represented in other psychiatric disorders, including anxiety disorders, post-traumatic stress disorder (PTSD), and schizophrenia. Anhedonia also has a prominent association with suicide, which represents a critical and pressing public health concern (Ducasse et al, 2018(Ducasse et al, , 2020.…”

Preliminary Evidence for Anhedonia as a Marker of Sexual Trauma in Female Adolescents

“…2 Anhedonia is also recognized as an important component of schizophrenia and post-traumatic stress disorder (PTSD), 3 as well as a contributor to suicide risk. 4 Increasingly, anhedonia is conceptualized as a transdiagnostic dimension 5 with multiple risk pathways leading to its emergence. 6 Previous studies have revealed that childhood trauma is a potent risk factor for the development of MDD; however, the impact of childhood trauma on specific depressive symptoms, is inadequately understood.…”

Key findings on bipolar disorders from the longitudinal FondaMental Advanced Center of Expertise-Bipolar Disorder (FACE-BD) cohort

“…Regarding suicidality, individuals with high affect lability were more likely to report suicidal ideation during follow-up 37 , whilst anhedonia predicted suicide events in the subgroup of participants who were depressed at baseline 38 .…”