Anhedonia in schizophrenia and psychosis spectrum disorders: An integrative review

Anhedonia and related motivation and pleasure (MAP) deficits are prevalent in schizophrenia and psychosis spectrum disorders, are generally persistent over time and show limited treatment response. These symptoms are of clinical importance as they contribute to the profound social impairment and reduced quality of life in schizophrenia and psychosis spectrum disorders. This selective narrative review examines methods for assessing anhedonia and MAP deficits followed by a summary of current research on factors that contribute to these symptoms with a focus on identifying continued gaps in our understanding. Literature spanning affect and hedonic responding is reviewed with an examination of the role of cognitive deficits, neural mechanisms, dysfunctional beliefs, behavior, sleep and environmental factors. Current treatment approaches are highlighted including recent advances in pharmacotherapy and psychosocial treatments.