Examining the relationship between pre-treatment anhedonia and treatment outcomes in individuals with anxiety or depression: A systematic review.

In 30 seconds

This systematic review examined whether pre-treatment anhedonia or lower reward sensitivity was associated with outcomes of psychotherapy, pharmacotherapy, or neuromodulation in people with anxiety or unipolar depressive disorders. Among 28 included articles, nine (32.1 %) linked greater anhedonia or lower reward sensitivity to worse response; four (14.3 %) linked it to better outcomes, eleven (39.3 %) reported mixed findings, and four (14.3 %) found no significant relationship. The authors concluded that inconsistent results do not support definitive conclusions about anhedonia as a treatment predictor.

Key findings

• Nine of 28 articles (32.1 %) associated higher anhedonia or lower reward sensitivity with worse treatment response.
• Four studies (14.3 %) linked anhedonia or lower reward sensitivity to better outcomes; eleven (39.3 %) reported mixed results.
• Four studies (14.3 %) found no significant relationship between pre-treatment anhedonia or reward sensitivity and treatment outcomes.

Why it matters

Anhedonia is a potential predictor that could help explain variation in response to treatments for anxiety and depression. However, the review found results pointing in different directions, so its clinical value remains uncertain. Clarifying whether anhedonia, its components, or reward-sensitivity measures relate to outcomes may help future research identify more informative predictors.

What to keep in mind

Findings were heterogeneous across treatments, designs, measures, and outcomes. Most studies were secondary analyses and were often inadequately powered, limiting definitive conclusions.