Anhedonia in substance use disorders: a systematic review of its nature, course and clinical correlates

There is growing evidence that anhedonia is a commonly experienced symptom among substance-using populations. This systematic review synthesises findings across a range of substances to address questions regarding the time course of anhedonia, how anhedonia relates to other symptoms of substance dependence and whether it is similarly prevalent across all addictive drugs. Method: A literature search was conducted on PubMed, PsycINFO and MEDLINE, yielding 32 studies that used selfreport measures of anhedonia among participants with a history of a substance abuse, dependence or long-term daily use of addictive substances. Results: Findings from these studies indicate that anhedonia (1) is elevated in samples dependent on a range of substances; (2) typically appears as a consequence of substance abuse or dependence, and diminishes with abstinence; and (3) predicts increased drug cravings and the likelihood of relapse in those attempting abstinence. Conclusions: The common experience of anhedonia in substance-dependent populations, and its relationship to relapse, emphasises the importance of developing therapeutic interventions that specifically target anhedonia in the treatment of all substance use disorders