Clinical burden and treatment satisfaction in patients diagnosed with major depressive disorder (MDD) with prominent anhedonia

Anhedonia is a key symptom of Major Depressive Disorder (MDD), however, there is limited knowledge about the impact of prominent anhedonia on clinical improvement and treatment satisfaction in patients diagnosed with MDD.

Data were analysed from the Adelphi-Real-World Depression Disease Specific Programme™, a cross-sectional survey of physicians and patients with MDD in the United States 2017–2018. Physicians rated patients’ severity of anhedonia symptom defined as ‘diminished interest/pleasure in activities’ from 1–5. When ≥3, patient indicated prominent anhedonia (MDD-ANH); no or low severity (1–2) patients were classified as other-MDD. Treatment patterns, overall improvement and treatment satisfaction were compared between MDD groups.

The study included 257 MDD-ANH and 1192 other-MDD patients. Mean (standard deviation) age was 49.5 (15.4) and 48.6 (17.0) years. MDD-ANH patients were more frequently prescribed benzodiazepines (32.0% vs 24.5%), selective/norepinephrine reuptake-inhibitors (22.9% vs 19.5%), atypical-antipsychotics (20.8% vs 12.1%) and norepinephrine/dopamine reuptake-inhibitors (21.2% vs 12.8%).
Physicians reported less satisfactory control over depression for MDD-ANH vs other-MDD (37.0% vs 66.7%; p < 0.001). MDD-ANH patients reported lower treatment satisfaction (moderately to completely satisfied: 71.5% vs 90.4%; p < 0.001).
MDD-ANH were less likely to report ‘much / much better’ improvement vs other-MDD via Clinical Global Impression Improvement Scale (53.7% vs 77.6%; p < 0.001). MDD-ANH were less likely to report significant improvement (38.7% vs 65.7%; p < 0.001).

Prominent anhedonia was associated with greater clinical burden, suggested by higher use of psychotropics, poor treatment satisfaction, and worse global improvement in MDD. Treatments that effectively address prominent anhedonia could alleviate clinical burden in patients with MDD.