Anhedonia in Major Depressive Disorder: Prevalence and Treatment Expectations and Satisfaction with Treatment Goals Among Patients and Physicians in Asia-Pacific

To explore the prevalence of anhedonia (ANH) in major depressive disorder (MDD) and treatment expectation and satisfaction among patients with MDD and physicians in the Asia-Pacific region. This cross-sectional web-based survey was conducted in April-May 2023 among physicians and individuals aged ≥18 years with self-reported physician diagnosis of MDD (9-item Patient Health Questionnaire [PHQ-9] score ≥ 10) further stratified by anhedonia as measured by the Snaith-Hamilton Pleasure Scale (SHAPS): MDD-ANH (SHAPS score > 2) and MDD non-ANH (SHAPS score ≤ 2). The study assessed the prevalence of anhedonia in MDD as well as the perspectives on the treatment of anhedonia in MDD in terms of expectations and satisfaction among patients and physicians. The regional estimated prevalence of MDD was 16.1% where 52.5% of MDD respondents had ANH (SHAPS score ≥2). Depressed mood, mental changes, and changes in sleeping patterns prompted MDD-ANH (n = 1448) or MDD non-ANH (n = 836) respondents to seek medical consultation. Respondents with MDD-ANH (vs MDD non-ANH) reported significantly higher levels of depression and anhedonia, longer treatment duration, and preferred switching their existing medications over adding additional medications (all, p < 0.001). Over half of physicians (55.0%) were not treating anhedonia separately. Anhedonia-specific treatment goals seemed important to all respondents, while avoiding suicidal ideation was significantly important to physicians. MDD-ANH respondents reported in general the lowest level of satisfaction with treatment goals than MDD non-ANH and physician, with "improvements in sexual satisfaction" being the treatment goal with the lowest level of satisfaction. This first large-scale study conducted across the Asia-Pacific region provides a recent update on the prevalence of MDD and anhedonia in MDD and highlights unmet needs in the current therapeutic landscape for anhedonia in MDD, emphasizing the need for novel treatment.