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| {{Search infobox}} | | __NOTOC__ |
| {{CMG}} | | {{Anhedonia}} |
| | {{CMG}} ; {{AE}} {{PB}} |
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| ==Overview==
| | '''For patient information, click [[Anhedonia (patient information)|here]]''' |
| In [[psychology]], '''anhedonia''' (< ''an-'' + Greek ''hēdonē'' pleasure ηδονή) is an inability to experience pleasure from normally pleasurable life events such as eating, exercise, and social or sexual interaction.
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| Anhedonia is recognized as one of the key symptoms of the [[mood disorder]] [[clinical depression|depression]] according to both the ''[[Diagnostic and Statistical Manual of Mental Disorders]]'' (DSM) and the ''[[ICD|International Statistical Classification of Diseases and Related Health Problems]]'' (ICD). Other than anhedonia, the DSM considers only depressed mood to be a key symptom. The ICD lists both depressed mood and fatigue or loss of energy as the other key symptoms. Anhedonia is also seen in [[schizophrenia|schizophrenic disorders]] and other [[mental disorder]]s.
| | ==[[Anhedonia overview|Overview]]== |
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| ==Etiology== | | ==[[Anhedonia historical perspective|Historical Perspective]]== |
| Researchers theorize that anhedonia may result from the breakdown in the [[nucleus accumbens|brain's reward system]], involving [[dopamine]] pathways. Two 2005 studies by Paul Keedwell MD of King's College found that certain sections of the brain in depressed subjects had to work harder to process happy thoughts.<ref>[http://www.mcmanweb.com/no_pleasure.htm "No Pleasure, No Reward -- Plenty of Depression"] by John McManamy; URL accessed [[2007-02-08]]</ref><ref>[http://apt.rcpsych.org/cgi/content/full/9/6/446 "Neural systems underlying affective disorders"] by Simon Surguladze, et al., Advances in Psychiatric Treatment (2003) 9: 446-455; URL accessed [[2008-02-08]]</ref>
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| Anhedonia is often experienced by drug addicts following withdrawal; in particular, stimulants like [[cocaine]] and [[amphetamine]]s cause anhedonia and [[Depression (mood)|depression]] by depleting [[dopamine]] and other important [[neurotransmitters]]. Very long-term addicts are sometimes said to suffer a permanent physical breakdown of their pleasure pathways, leading to anhedonia on a permanent or semi-permanent basis due to the extended overworking of the neural pleasure pathways during active [[addiction]] (particularly as regards [[cocaine]] and [[methamphetamine]]). In this circumstance, activities still may be pleasurable, but can never be as pleasurable to people who have experienced the comparatively extreme pleasure of the drug experience. The result is apathy towards healthy routines by the addict. Extended periods of healthy lifestyles away from active addiction have been shown to reverse these feelings.
| | ==[[Anhedonia pathophysiology|Pathophysiology]]== |
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| ==Differential Diagnosis of the causes of Anhedonia== | | ==[[Anhedonia causes|Causes]]== |
| (In alphabetical order)
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| *[[Addiction]]
| | ==[[Anhedonia epidemiology and demographics|Epidemiology and Demographics]]== |
| *[[Amphetamines]]
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| *[[Clinical depression]]
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| *[[Cocaine]]
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| *[[Disorganized schizophrenia]]
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| *[[Dysthymia]]
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| *[[Schizophrenia]]
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| ==Significance in depression== | | ==[[Anhedonia risk factors|Risk factors]]== |
| As a clinical symptom in depression, anhedonia rates highly in making a diagnosis of this disorder. The DSM describes a "lack of interest or pleasure" but these can be hard to tease apart given that people become less interested in things which do not give them pleasure. The DSM criterion of weight loss is probably related to it and many depressed people with this symptom describe a lack of enjoyment from food.
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| '''Bold text'''
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| ==Sexual anhedonia== | | ==Diagnosis== |
| Sexual anhedonia is known as 'ejaculatory anhedonia'. This rare condition means that the person will [[ejaculate]] with no accompanying sense of pleasure. This condition is most frequently found in males, but women can suffer from lack of pleasure when the body goes through the [[orgasm]] process as well.
| | [[Anhedonia diagnostic criteria|Diagnostic Criteria]], [[Anhedonia history and symptoms|History and Symptoms]] |
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| Sexual anhedonia may be caused by:
| | ==Treatment== |
| *[[Hyperprolactinaemia]]
| | [[Anhedonia medical therapy|Medical Therapy]], [[Anhedonia primary prevention|Primary Prevention]], [[Anhedonia cost-effectiveness of therapy|Cost-Effectiveness of Therapy]], [[Anhedonia future or investigational therapies|Future or Investigational Therapies]] |
| *Hypoactive sexual desire disorder (HSDD), also called [[inhibited sexual desire]]
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| *Low levels of the hormone [[testosterone]]
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| *Spinal cord injury
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| *Use of [[SSRI]] antidepressants
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| A urological examination and blood tests can determine the cause of a specific case of sexual anhedonia. If no physiological problems are found, one should seek treatment via psychotherapy with a certified sex therapist, or psychotherapist.
| | ==Related Chapters== |
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| Patients may be prescribed sustained-release [[bupropion]] to aid in treatment, because bupropion has been shown to increase sexual desire and intensity of orgasm.
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| ==See also==
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| {{wiktionarypar|anhedonia}}
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| *[[Dysthymia]]
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| *[[Clinical depression]]
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| ==References==
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| {{reflist|2}}
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| {{SIB}}
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| | [[Category:Psychiatry]] |
| | [[Category:Neurology]] |
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| [[Category:Psychiatry]]
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| [[Category:Mature chapter]]
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| [[Category:Symptoms]]
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| [[Category:Psychological conditions]]
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| [[Category:Mood disorders]]
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| [[Category:Ddx]]
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| [[de:Anhedonie]]
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| [[es:Anhedonia]]
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| [[fr:Anhédonie]]
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| [[it:Anedonia]]
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| [[pl:Anhedonia]]
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| [[pt:Anedonia]]
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| [[ru:Ангедония]]
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| [[sr:Анхедонија]]
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