Suicide Life Threat Behav. 2020;00:1–9. wileyonlinelibrary.com/journal/sltb
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1 © 2020 The American Association of Suicidology
INTRODUCTION
Anhedonia, the difficulty in experiencing pleasure from plea-
surable experiences, affects many areas of life. It includes
physical anhedonia (PA), an inability to feel physical pleasure,
and social anhedonia (SA), a diminished capacity for plea-
sure in social activities (Chapman et al., 1976). Anhedonia
may occur in any population, but it is far more common in
Received: 21 February 2020
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Revised: 4 August 2020
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Accepted: 5 August 2020
DOI: 10.1111/sltb.12724
ORIGINAL ARTICLE
Physical and social anhedonia are associated with suicidality in
major depression, but not in schizophrenia
Marina Sagud MD, PHD
1,2
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Lucija Tudor MSc
3
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Lucija Šimunić MD
2
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Dejana Jezernik MD
2
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Zoran Madžarac MD
2
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Nenad Jakšić MSc
2
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Alma Mihaljević Peleš
MD, PhD
1,2
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Bjanka Vuksan-Ćusa MD, PhD
2
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Ivona Šimunović Filipčić MD, PhD
2
|
Ivana Stefanović MD
4
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Biljana Kosanović Rajačić MD
2
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Suzan Kudlek Mikulić MD, PhD
2
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Nela Pivac DVM, PhD
3
*Equally contributing authors.
1
School of Medicine, University of
Zagreb, Zagreb, Croatia
2
Department of Psychiatry and
Psychological Medicine, University
Hospital Centre Zagreb, Zagreb, Croatia
3
Laboratory for Molecular
Neuropsychiatry, Division of Molecular
Medicine, Rudjer Boskovic Institute,
Zagreb, Croatia
4
General Hospital "Dr. Josip Benčević",
Slavonski Brod, Croatia
Correspondence
Nela Pivac, Laboratory for Molecular
Neuropsychiatry, Division of Molecular
Medicine, Rudjer Boskovic Institute,
Zagreb, Croatia.
Email: npivac@irb.hr
Funding information
Medicinski Fakultet, Sveučilište
u Zagrebu, Grant/Award Number:
Biomarkers of therapeutic response in
schizophreni; University of Zagreb,
Grant/Award Number: BM106
Abstract
Objective: This cross-sectional study investigated the association of physical and
social anhedonia with suicidality in patients with major depressive disorder (MDD),
schizophrenia, and in non-psychiatric controls.
Method: All participants completed the revised Physical Anhedonia Scale (RPAS)
and the revised Social Anhedonia Scale (RSAS) and were subdivided according to
positive life-time suicide attempt history. MDD patients were evaluated with the
Montgomery-Ãsberg Depression Rating Scale (MADRS), healthy respondents with
the Patient Health Questionnaire-9 (PHQ-9), and schizophrenia patients with the
Calgary Depression Scale for Schizophrenia (CDSS).
Results: In 683 study participants, the prevalence of each anhedonia was the highest
in MDD, followed by schizophrenia, and lowest in the control group. Among MDD
patients, those with physical and social anhedonia had greater rates of recent suicidal
ideation, while a higher frequency of individuals with life-time suicide attempts was
detected in those with only social anhedonia. In contrast, no association between ei-
ther anhedonia and life-time suicide attempts or recent suicidal ideation was found in
patients with schizophrenia.
Conclusions: Assessing social and physical anhedonia might be important in MDD
patients, given its association with both life-time suicide attempts and recent suicidal
ideation. Suicidality in schizophrenia, while unrelated to anhedonia, might include
other risk factors.
KEYWORDS
anhedonia, depression, suicide