Anhedonia in schizophrenia

Abstract

This review highlights key issues and recent progress in understanding the epidemiology, phenomenology, etiology, and treatment of anhedonia in schizophrenia. A reduced pleasure capacity has been recognized as an important feature of the illness since the time of Kraepelin and Bleuler. However, it remains poorly understood for many reasons, including the phenotypic heterogeneity of schizophrenia, the multidimensionality and multifactorial etiology of anhedonia, and the difficulties inherent in the scientific analysis of subjective emotional experiences. We do know that anhedonia is common in schizophrenia, that it has significant negative consequences, and that current treatments are insufficient. Better assessment tools, greater understanding of biological and psychosocial mechanisms, and novel pharmacologic and psychosocial interventions are sorely needed. Anhedonia has received increasing attention in recent years, and there is optimism that the new Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative on negative symptoms will catalyze rapid progress in the near future.