Anhedonia in irritable bowel syndrome and in inflammatory bowel diseases and its relationship with abdominal pain

BACKGROUND: Anhedonia is the lowered ability to experience pleasure from rewarding or enjoyable activities and is considered a symptom of depression. Inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) are frequently accompanied by psychiatric disorders such as depression. However, to our knowledge, studies have yet to investigate the anhedonia in these patients. Our aim was to study the level of anhedonia in patients with IBD and IBS in comparison with healthy controls (HC), and to relate anhedonia levels with the severity of abdominal pain. METHODS: We consecutively recruited IBD and IBS patients. All patients fulfilled the Snaith-Hamilton Pleasure Scale (SHAPS), a self-rating scale consisting of 14 items that cover the domains of social interaction, food, and drink, sensory experiences, achievement and pastimes, and the Beck Depression Inventory-II (BDI-II) to screen for depression. Moreover, we calculated abdominal pain on a (0-100) Visual Analog Scale (VAS) in all patients. KEY RESULTS: We enrolled 120 patients (64 IBD and 56 IBS) and 81 HC. Among IBD patients, 34 had Crohn's disease and 30 ulcerative colitis. All patients as a whole had significantly higher SHAPS and BDI-II scores than HC (1.3 ± 1.5 vs 0.8 ± 0.1; P = 0.01 and 10.4 ± 7.5 vs 5.9 ± 4.9; P < 0.001, respectively), while no significant differences were found among groups. SHAPS score showed a significant correlation in only a few statements of BDI-II. In our cohort, a multivariate regression analysis showed that SHAPS score was significantly related to current abdominal pain (0-100 VAS) (P = 0.03) independent of gender and age. CONCLUSIONS AND INFERENCES: The level of anhedonia was higher in all patients compared to healthy controls. The more the subject is anhedonic, the higher the VAS scale for abdominal pain. This study suggests that anhedonia would need to be very carefully weighed in IBD and IBS patients.