Journal Mobile Options
Table of Contents
Vol. 52, No. 1, 2005
Issue release date: June 2005
Neuropsychobiology 2005;52:37–44

Anhedonia and Substance-Related Symptoms in Detoxified Substance-Dependent Subjects: A Correlation Study

Janiri L. · Martinotti G. · Dario T. · Reina D. · Paparello F. · Pozzi G. · Addolorato G. · Di Giannantonio M. · De Risio S.
aInstitute of Psychiatry and Psychology, Treatment Unit for Alcoholism and Multiple Drug Abuse, and bInstitute of Internal Medicine, Catholic University, Rome, Italy

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


Anhedonia is a condition in which the capacity of experiencing pleasure is totally or partially lost, frequently occurring in mood disorders, as a negative symptom in schizophrenia, and in substance use disorders. In order to test a set of instruments for anhedonia in a population of detoxified opiate, alcohol and multiple substance-dependent subjects, 70 individuals were recruited from three different clinical settings. The following scales were applied: Snaith-Hamilton Pleasure Scale (SHAPS), Bech-Rafaelsen Melancholia Scale (BRMS), Scale for the Assessment of Negative Symptoms (SANS), specific withdrawal scales, and visual analogue scales (VAS) for hedonic capability and substance craving. The scales measuring anhedonia either directly (SHAPS, VAS for hedonic capability) or in some key items (SANS, BRMS) were significantly correlated with each other. The period of time since detoxification was inversely correlated with anhedonia and withdrawal symptomatology. Craving was positively correlated with anhedonia. Out of the total sample, only 18.5% could be defined as psychometrically anhedonic. The same correlations were found in this subsample. The composite instrument employed for assessing anhedonia and hedonic capability was found to be sensitive enough to detect such a dimension in the population considered, with the single scales significantly interrelated. In conclusion, we found interrelations between hedonic capability, craving and protracted withdrawal, particularly in opiate-dependent subjects. The strongest association occurred between hedonic capability and craving.

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. Ribot T: La psychologie des sentiments. Paris, Felix Alcan, 1896.
  2. Loas G, Pierson A: Anhedonia in psychiatry: A review. Ann Med Psychol (Paris) 1989;147:705–717.
  3. Klein DF: Endogenomorphic depression. A conceptual and terminological revision. Arch Gen Psychiatry 1974;31:447–454.
  4. Andreasen NC: Negative symptoms in schizophrenia: Definition and reliability. Arch Gen Psychiatry 1982;39:784–788.
  5. Silverstone PH: Is anhedonia a good measure of depression? Acta Psychiatr Scand 1991;83:249–250.
  6. Oei TI, Verhoeven WM, Westenberg HG, Zwart FM, van Ree JM: Anhedonia, suicide ideation and dexamethasone nonsuppression in depressed patients. J Psychiatr Res 1990;24:25–35.
  7. Fawcett J: The morbidity and mortality of clinical depression. Special Issue: Affective disorders: Current and future perspectives. Int Clin Psychopharmacol 1993;8:217–220.
  8. Loas G: Vulnerability to depression: A model centered on anhedonia. J Affect Disord 1996;41:39–53.
  9. Heinz A, Schmidt LG, Reischies FM: Anhedonia in schizophrenic, depressed, or alcohol-dependent patients: Neurobiological correlates. Pharmacopsychiatry 1994;27:7–10.
  10. Gawin FH, Ellinwood EH Jr: Cocaine and other stimulants. Actions, abuse and treatment. N Engl J Med 1988;318:1173–1182.
  11. Bovasso GB: Cannabis abuse as a risk factor for depressive symptoms. Am J Psychiatry 2001;158:2033–2037.
  12. Miller NS, Summers GL, Gold MS: Cocaine dependence: Alcohol and other drug dependence and withdrawal characteristics. J Addict Disord 1993;12:25–35.
  13. Jaffe H, Knappe CM, Ciraulo DA: Opiates: Clinical aspects; in Lowinson JH, et al (eds): Substance Abuse – A Comprehensive Textbook, ed 3. Baltimore, Williams & Wilkins, 1997, p 158.
  14. Guyon A, Assouly-Besse F, Biala G, Puech AJ, Thiébot MH: Potentiation by low doses of selected neuroleptics of food-induced conditioned place preference in rats. Psychopharmacology 1993;110:460–466.
  15. Willner P: Validity, reliability and utility of the chronic mild stress model of depression: A 10-year review and evaluation. Psychopharmacology 1997;134:319–329.
  16. Schmidt K, Nolte-Zenker B, Patzer J, Bauer M, Schmidt LG, Heinz A: Psychopathological correlates of reduced dopamine receptor sensitivity in depression, schizophrenia, and opiate and alcohol dependence. Pharmacopsychiatry 2001;34:66–72.
  17. Diana M, Pistis M, Muntoni A, Gessa G: Mesolimbic dopaminergic reduction outlasts ethanol withdrawal syndrome: Evidence of protracted abstinence. Neuroscience 1996;71:411–415.
  18. Robertson MW, Leslie CA, Bennet JP Jr: Apparent synaptic dopamine deficiency induced by withdrawal from chronic cocaine treatment. Brain Res 1991;538:337–339.
  19. Miller NS, Dackis CA, Gold MS: The relationship of addiction, tolerance, and dependence to alcohol and drugs: A neurochemical approach. J Subst Abuse Treat 1987;4:197–207.
  20. Martin-Soelch C, Chevalley AF, Kunig G, Missimer J, Magyar S, Mino A: Changes in reward-induced brain activation in opiate addicts. Eur J Neurosci 2001;14:1360–1368.
  21. Volkow ND, Fowler JS, Wang GJ, Goldstein RZ: Role of dopamine, the frontal cortex and memory circuits in drug addiction: Insight from imaging studies. Neurobiol Learn Mem 2002;78:610–624.
  22. Volkow ND, Wang GJ, Fowler JS, Logan J, Gatley SJ, Hitzemann R, Chen AD, Dewey SL, Pappas N: Decreased striatal dopaminergic responsiveness in detoxified cocaine-dependent subjects. Nature 1997;386:830–833.
  23. Chapman LJ, Chapman JP, Raulin ML: Scales for physical and social anhedonia. J Abnorm Psychol 1976;85:374–382.
  24. Fawcett J, Clark DC, Scheftner WA, Gibbons RD: Assessing anhedonia in psychiatric patients. Arch Gen Psychiatry 1983;40:79–84.
  25. Snaith RP, Hamilton M, Morley S, Humayan A, Hargreaves D, Trigwell P: A scale for the assessment of hedonic tone. The Snaith Hamilton Pleasure Scale. Br J Psychiatry 1995;167:99–103.
  26. Lampe IK, Kahn RS, Heeren TJ: Apathy, anhedonia, and psychomotor retardation in elderly psychiatric patients and healthy elderly individuals. J Geriatr Psychiatry Neurol 2001;14:11–16.
  27. Silver H, Shlomo N: Anhedonia and schizophrenia: How much is in the eye of the beholder? Compr Psychiatry 2002;43:65–68.
  28. Stevens A, Schwarz J, Schwarz B, Ruf I, Kolter T, Czekalla J: Implicit and explicit learning in schizophrenics treated with olanzapine and with classic neuroleptics. Psychopharmacology (Berl) 2002;160:299–306.
  29. Loas G, Dubal S, Perot P, Tirel F, Nowaczkowski P, Pierson A: Validation of the French version of the Snaith-Hamilton Pleasure Scale (SHAPS, Snaith et al., 1995). Determination of the statistical parameters in 208 normal subjects and 103 hospitalized patients presenting with depression or schizophrenia. Encephale 1997;23:454–458.
  30. Andreasen NC: The Scale for the Assessment of Negative Symptoms (SANS): Conceptual and theoretical foundations. Br J Psychiatry 1989;suppl 7:49–58.
  31. Bersani G, Orlandi V, Gherardelli S, Pancheri P: Cannabis and neurological soft signs in schizophrenia: Absence of relationship and influence on psychopathology. Psychopathology 2002;35:289–295.
  32. Dollfus S, Petit M: Negative symptoms in schizophrenia: Their evolution during an acute phase. Schizophr Res 1995;17:187–194.
  33. Tollefson GD, Sanger TM: Negative symptoms: A path analytic approach to a double-blind, placebo- and haloperidol-controlled clinical trial with olanzapine. Am J Psychiatry 1997;154:466–474.
  34. Bech P: The Bech-Rafaelsen Melancholia Scale (MES) in clinical trials of therapies in depressive disorders: A 20-year review of its use as outcome measure. Acta Psychiatr Scand 2002;106:252–264.
  35. Muller MJ, Wetzel H, Benkert O: Differential effects of high-dose amisulpride versus flupentixol on latent dimensions of depressive and negative symptomatology in acute schizophrenia: An evaluation using confirmatory factor analysis. Int Clin Psychopharmacol 2002;17:249–261.
  36. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh G: An interview for measuring depression. Arch Gen Psychiatry 1961;4:561–571.
  37. Liraud F, Verdoux H: Which temperamental characteristics are associated with substance use in subjects with psychotic and mood disorders? Psychiatry Res 2000;93:63–72.
  38. Marra D, Warot D, Payan C, Hispard E, Dally S, Puech AJ: Anhedonia and relapse in alcoholism. Psychiatry Res 1998;80:187–196.
  39. Uslaner J, Kalechstein A, Richter T, Ling W, Newton T: Association of depressive symptoms during abstinence with the subjective high produced by cocaine. Am J Psychiatry 1999;156:1444–1446.
  40. Mezzich JE, Dow JT, Rich CL, Costello AJ, Himmelhoch JM: Developing an efficient clinical information system for comprehensive psychiatry institute. Behav Res Methods Comput 1981;13:464–478.
  41. American Psychiatric Association (APA): Diagnostic and Statistical Manual of Mental Disorders, ed 4. Washington, APA, 1994.
  42. McCann MJ, Miotto K, Rawson RA, Huber A, Shoptaw S, Ling W: Outpatient non-opioid detoxification for opioid withdrawal. Who is likely to benefit? Am J Addict 1997;6:218–223.
  43. Lejoyeux M, Solomon J, Ades J: Benzodiazepine treatment for alcohol-dependent patients. Alcohol Alcohol 1998;33:563–575.
  44. Gossop M: The development of a Short Opiate Withdrawal Scale (SOWS). Addict Behav 1990;15:487–490.
  45. Sullivan JT, Sykora K, Schneiderman J, Naranjo CA, Sellers EM: Assessment of alcohol withdrawal: The revised clinical institute withdrawal assessment for alcohol scale (CIWA-Ar). Br J Addict 1989;84:1353–1357.
  46. Dervaux A, Baylé FJ, Laqueille X, Bourdel MC, Le Borgne MH, Olié JP, Krebs MO: Is substance abuse in schizophrenia related to impulsivity, sensation seeking, or anhedonia? Am J Psychiatry 2001;158:492–494.
  47. Seifert J, Metzner C, Paetzold W, Borsutzky M, Passie T, Rollnik J, Wiese B, Emrich HM, Schneider U: Detoxification of opiate addicts with multiple drug abuse: A comparison of buprenorphine vs. methadone. Pharmacopsychiatry 2002;35:159–164.
  48. Gilbert P, Allan S, Brough S, Melley S, Miles JNV: Relationship of anhedonia and anxiety to social rank, defeat and entrapment. J Affect Disord 2002;71:141–151.
  49. Elman I, Karlsgodt KH, Gastfriend DR, Chabris CF, Breiter HC: Cocaine-primed craving and its relationship to depressive symptomatology in individuals with cocaine dependence. J Psychopharmacol 2002;16:163–167.
  50. Zilberman ML, Tavares H, el-Guebaly N: Relationship between craving and personality in treatment-seeking women with substance-related disorders. BMC Psychiatry 2003;3:1.
  51. Sherman JE, Zinser MC, Sideroff SI, Baker TB: Subjective dimensions of heroin urges: Influence of heroin related and affectively negative stimuli. Addict Behav 1989;14:611–623.
  52. Elman I, Karlsgodt KH, Gastfriend DR, Chabris CF, Breiter HC: Cocaine-primed craving and its relationship to depressive symptomatology in individuals with cocaine dependence. J Psychopharmacol 2002;16:163–167.
  53. Janiri L, Calvosa F, Dario T, Pozzi G, Ruggeri A, Addolorato G, De Risio S: The Italian version of the Obsessive Compulsive Drinking Scale: validation, comparison with the other versions and difference between type 1 and type 2-like alcoholics. Drug Alcohol Depend 2004;74:187–195.
  54. Tatsuzawa Y, Yoshimasu H, Moriyama Y, Furusawa T, Yoshino A: Validation study of the Japanese version of the Obsessive-Compulsive Drinking Scale. Psychiatry Clin Neurosci 2002;56:91–95.
  55. Singleton EG, Tiffany ST, Henningfield JE: Development and validation of a new questionnaire to assess craving for alcohol. 56th Annual Meeting of College on Problems of Drug Dependence, Palm Beach, July 1994.
  56. Verheul R, Brink WVD, Geerlings P: A three-pathway psychobiological model of craving for alcohol. Alcohol Alcohol 1999;34:197–222.

Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50