Relationship between anhedonia and impulsivity in schizophrenia, major depression and schizoaffective disorder Mostafa Amr a, *, Fernando Madalena Volpe b a Department of Psychiatry, College of Medicine, Mansoura University, Mansoura, Egypt b Teaching and Research Management, Hospital Foundation of Minas Gerais – FHEMIG, Brazil 1. Introduction Anhedonia and impulsivity are prominent symptoms of many psychiatric disorders, notably schizophrenia and major depression (Iancu et al., 2010; Der-Avakian and Markou, 2012). The term anhedonia, from the Greek an-, without, and hedone, pleasure (D’Haenen, 1990), was introduced in 1896 by Ribot and was defined as the loss of the capacity or reduced ability to feel pleasure (Snaith, 1992). Chapman et al. (1976) have defined two different types of hedonic deficits: physical anhedonia and social anhedonia. Physical anhedonia represents an inability to feel physical pleasures (such as from eating, touching and sex). Social anhedonia describes the incapacity to experience interpersonal pleasure (such as being with and talking to others). In schizophrenia, anhedonia is associated with negative symptoms, particularly flattened affect. Andreasen (1982) has incorporated hedonic deficit into the diagnostic criteria for the ‘negative syndrome’ of schizophrenia, defining a specific ‘anhedonia/asociality’ subscale in the Scale for the Assessment of Negative Symptoms (SANS). In depression, anhedonia is one of the two core symptoms (American Psychiatric Association, 2000). In the same direction, the International Classification of Diseases, 10th revision (ICD-10), (World Health Organization (WHO), 1992) includes curbing of interests, and the inability to feel pleasure and to experience pleasant emotions, among the ‘somatic’ symptoms of major depression. Impulsivity is a multidimensional construct and may be defined as a predisposition toward rapid unplanned reactions to themselves or others (Moeller et al., 2001). It has been proposed to be associated to anhedonia as a dysfunctional adaptation to very high threshold for pleasurable stimuli (Marissen et al., 2012), however, there is little evidence supporting that hypothesis. Both anhedonia and impulsivity predict worsening of prognosis in the mentally ill. Substance abuse (Leventhal et al., 2010), suicidality (van Spijker et al., 2010), functional impairment (Herbener et al., 2005; Strauss et al., 2011; Jime ´ nez et al., 2012), and also complicated treatment planning and lengthened hospital stays (Hoptman et al., 2002; Moeller et al., 2002) are common consequences of those features. Asian Journal of Psychiatry 6 (2013) 577–580 A R T I C L E I N F O Article history: Received 19 March 2013 Received in revised form 21 August 2013 Accepted 2 September 2013 Keywords: Anhedonia Impulsivity Schizophrenia Major depressive disorder Schizoaffective disorder A B S T R A C T Background: Anhedonia and impulsivity are prominent symptoms of many psychiatric disorders and may indicate worse prognosis, notably in schizophrenia and major depression. Despite the convergence of negative outcomes from both dimensions, the relationship between anhedonia and impulsivity in psychiatric disorders has been seldom directly assessed. The objective of the present study is to examine the correlations between anhedonia and impulsivity in three diagnostic groups: major depression, schizophrenia and schizoaffective disorder. Sampling and methods: 121 outpatients (Mansoura University Hospital, Egypt) with major depressive disorder (N = 29), schizophrenia (N = 59), and schizoaffective disorder (N = 33), were assessed and responded to the Beck Depression Inventory, Barrat’s Impulsivity Scale-11, and Chapman’s Social and Physical Anhedonia Scales. Results: Physical and social anhedonia scores were negatively correlated to impulsivity scores in major depression patients. Conversely, higher scores in physical and social anhedonia predicted higher impulsivity scores in schizophrenia. No correlations between impulsivity and anhedonia were evidenced among schizoaffectives. Conclusion: The relationship between self-reported physical and social anhedonia and impulsivity is diagnosis-specific. ß 2013 Elsevier B.V. All rights reserved. * Corresponding author. Tel.: +20 402972920. E-mail addresses: mostsfapsy@yahoo.com, mostafapsy@yahoo.com (M. Amr). Contents lists available at ScienceDirect Asian Journal of Psychiatry jo u rn al h om epag e: ww w.els evier.c o m/lo cat e/ajp 1876-2018/$ – see front matter ß 2013 Elsevier B.V. All rights reserved. http://dx.doi.org/10.1016/j.ajp.2013.09.002