TOPLINE

Patients with treatment-resistant depression (TRD) and chronic anhedonia (defined as the persistent inability to experience pleasure) were significantly more likely to report suicidal ideation or suicide attempts in the month preceding assessment than those without chronic anhedonia, a study showed. 

METHODOLOGY

• Researchers conducted a retrospective cohort study of 160 participants from the START Clinic for Mood and Anxiety Disorders in Toronto, Canada, of whom 97 met the criteria for TRD (mean age, 39.3 years; 49% women).
• TRD was defined as major depressive disorder characterized by an inadequate response to at least two distinct antidepressants at appropriate dosages for a sufficient duration.
• Anhedonia was classified using Mini International Neuropsychiatric Interview (MINI) 6.0.0 module A as past (symptoms only before the 2 weeks preceding assessment), acute (symptoms only within the 2 weeks preceding assessment), or chronic (symptoms both within and beyond the 2-week window) anhedonia.
• Suicidality was assessed using the MINI Suicide Module, covering suicidal thoughts, previous attempts, and other risk factors.

TAKEAWAY

• 91.3%, 58.7%, and 57.6% of patients with TRD reported having past, acute, and chronic anhedonia, respectively.
• Among participants with TRD, the frequencies of suicidal ideation and suicide attempts in the month before assessment were 2.4-fold (P = .049) and 3.9-fold (P = .035) higher, respectively, in those with chronic anhedonia than in those with past or acute anhedonia.
• A greater proportion of participants with TRD and chronic anhedonia than with TRD and past or acute anhedonia reported suicidal ideation in the month before assessment (65.2% vs 43.8%). However, a smaller proportion of participants with TRD and chronic anhedonia than with TRD and past or acute anhedonia reported suicidal attempts in the month before assessment (17.4% vs 24.2%).

IN PRACTICE

"Clinicians treating patients with TRD should assess not only the presence but also the persistence of anhedonic symptoms. Patients reporting both historical and current anhedonia may be at significantly elevated risk for suicidal ideation and attempt, and this can be screened with 2 simple questions from the MINI," the authors wrote.

SOURCE

The study was led by Tia Sternat, PhD, START Clinic for Mood and Anxiety Disorders, Toronto, Canada. It was published online on September 21 in The Journal of Clinical Psychiatry.

LIMITATIONS

The study was limited by its cross-sectional design and reliance on self-report measures, small sample size, and potential confounding by other factors. The key comparison was between chronic anhedonia and past or acute anhedonia subgroups rather than any anhedonia vs none. Additionally, the study did not use a validated anhedonia-specific measure and did not discern anticipatory and consummatory components. 

DISCLOSURES

The study received no specific funding. Disclosure information for the study authors is available in the original study publication.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.