Anhedonia and Reward Processing in Mood Disorders

Anhedonia, the diminished capacity to experience pleasure or interest, is a core feature of mood disorders such as major depressive disorder and bipolar depression. Contemporary research frames anhedonia not merely as a failure of hedonic enjoyment but as a multifaceted disruption of reward circuits encompassing motivational drive (“wanting”), consummatory pleasure (“liking”) and associative learning about positive outcomes. Neurobiological investigations have identified striatal–prefrontal dysconnectivity, altered dopaminergic signalling and blunted ventral striatal activation during reward anticipation as key mechanisms. Behavioural studies reveal consistent impairments in effort-based decision-making, reward bias and reinforcement learning in affected individuals, correlating with illness severity and treatment resistance. Emerging interventions target these deficits through pharmacological modulation of kappa and mu opioid receptors, glutamatergic agents such as ketamine, and novel psychotherapeutic approaches designed specifically to augment positive valence system functioning. Understanding anhedonia’s subtypes has practical implications for personalised treatment, informing both medication choice and cognitive-behavioural strategies to restore reward sensitivity and improve functional outcomes worldwide.

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Anhedonia and Reward Processing in Mood Disorders publication trend

The graph below shows the total number of articles in anhedonia and reward processing in mood disorders across all publications each year (not limited to Nature Index journals).

Technical terms

Anhedonia: A reduced ability to feel pleasure or interest in normally enjoyable activities.

Reinforcement learning: The cognitive process by which individuals adjust behaviour based on past rewards and punishments.

Ventral striatum: A subcortical brain region central to processing reward anticipation and motivation.

Motivational anhedonia: A subtype characterised by diminished drive to pursue rewards.

Consummatory anhedonia: A subtype marked by impaired enjoyment of rewards when they are received.

References

1. Preliminary clinical and cost effectiveness of augmented depression therapy versus cognitive behavioural therapy for the treatment of anhedonic depression (ADepT): a single-centre, open-label, parallel-group, pilot, randomised, controlled trial. EClinicalMedicine (2023).
2. Efficacy and safety of aticaprant, a kappa receptor antagonist, adjunctive to oral SSRI/SNRI antidepressant in major depressive disorder: results of a phase 2 randomized, double-blind, placebo-controlled study. Neuropsychopharmacology (2024).
3. Characterizing anhedonia: A systematic review of neuroimaging across the subtypes of reward processing deficits in depression. Cognitive, Affective, & Behavioral Neuroscience (2020).
4. Reward-Processing Behavior in Depressed Participants Relative to Healthy Volunteers. JAMA Psychiatry (2020).
5. Measuring anhedonia: impaired ability to pursue, experience, and learn about reward. Frontiers in Psychology (2015).