Disease burden associated with prominent anhedonia in patients with major depressive disorder (MDD) from Adelphi Depression Disease Specific Program

Anhedonia is a core symptom of major depressive disorder (MDD). However, there is a lack of understanding of the healthcare and humanistic burden associated with prominent anhedonia in patients with MDD.

Data were drawn from the Adelphi-Real-World Depression Disease Specific Programme™, a cross-sectional survey of physicians and patients in the United States, 2017-2018. Patients with a physician-reported score of ≥3-out-of-5 for ‘diminished interest/pleasure in activities’ were considered to have prominent anhedonia (MDD-ANH). Patients with scores 1–2 (no or low severity) were classified as ‘other-MDD’. Physician-reported symptom burden and resource use, and patient-reported Work Productivity and Activity Impairment scores were compared between MDD groups.

The survey included 257 MDD-ANH and 1192 other-MDD patients. Mean (standard deviation) patient age=49.5 (15.4); 48.6 (SD 17.0) years. MDD-ANH patients showed higher prevalence of depressive mood (84.8% vs 59.9%; p < 0.001), interrupted sleep (48.6% vs 26.5%; p < 0.001), fear of social situations (30.4% vs 18.0%; p < 0.001), sexual dysfunction (17.5% vs 4.5%; p < 0.001) and weight gain (26.9% vs 14.9%; p < 0.001). MDD-ANH patients experienced more hospitalizations (21 per 100 vs 7 per 100; p < 0.001), higher lost productivity due to absenteeism (12.7 vs 2.9; p < 0.001), presenteeism (31.7 vs 21.0; p < 0.001) and overall work impairment (34.2 vs 22.5; p < 0.001).

Prominent anhedonia in MDD was associated with higher symptom burden, increased work and activity impairment and greater number of hospitalizations, suggesting a greater burden of disease. This study highlights the need for treatments that target prominent anhedonia and improve outcomes in patients with MDD.