Symptoms of anhedonia, not depression, predict the outcome of treatment of cocaine dependence

The purpose of this paper is to reanalyze data from two studies to determine if anhedonia specifically, rather than depression overall, predicts treatment outcome for patients with cocaine use disorders. Measures of baseline anhedonia symptoms were created using anhedonia items from the Beck Depression Inventory (BDI) to re-examine National Institute on Drug Abuse Cocaine Collaborative Treatment study data (Crits-Christoph et al., 1999) and the contingency management group from the McKay et al. (2010) trial. Baseline anhedonia was used to predict cocaine abstinence rates across the treatment period in both studies. Anhedonia was a significant predictor of cocaine abstinence, even when overall depression scores excluding anhedonia were included in the models. The development of treatments to target individuals with cocaine use disorder who have symptoms of anhedonia has the potential to improve overall outcomes for those with this disorder. •Not all patients benefit from psychosocial treatments for cocaine use disorder.•Anhedonia was found to be associated with relatively poorer outcomes for contingency management treatment.•Anhedonia was also found in another study to be associated with relatively poorer outcomes across a range of psychosocial treatments.•The development/testing of treatments for patients with cocaine use disorder and symptoms of anhedonia may improve outcomes.