Anhedonia as a Transdiagnostic Phenomenon: Neurobiological, Clinical, and Therapeutic Approaches

Abstract

Anhedonia, classically defined as the inability to experience pleasure, was introduced in 1897 by the French philosopher and psychologist Théodule Armand Ribot. Although this term is still used, it has undergone conceptual modifications because the dichotomy of the original description is insufficient to capture the complexity of its components (Pérez Rincón, 2014). The hedonic experience is a dynamic and cyclical process that begins with a state with an individual reference range, known as hedonic tone, which determines each person’s capacity to experience pleasure and happiness. Currently, anhedonia is considered a transdiagnostic, multidimensional, and dynamic construct consisting of multiple attributes or valences whose combination determines a wide variety of behavioral phenotypes. These may be transiently altered or represent a more enduring trait. The presence of anhedonia in various psychopathological disorders is associated with greater severity, a worse prognosis, and an increased risk of suicide. For this reason, effective psychotherapeutic and pharmacological treatments are essential. The objective of this paper, a narrative review, was to offer an expert clinical opinion, summarizing the evidence on some anhedonia phenotypes and their potential treatments. Three adapted clinical vignettes are also included as examples