Anhedonia of Patients with Schizophrenia and Schizoaffective Disorder is Attributed to Personality-Related Factors Rather than to State-Dependent Clinical Symptoms.

Purpose: The aim of the current study was to explore the concurrent attribution of illness- and personality-related variables to the levels of physical and social anhedonia in patients with schizophrenia (SZ) and schizoaffective disorder (SA).

Method: Eighty-seven stable patients with SZ/SA were assessed using the revised Physical Anhedonia Scale (PAS) and the Social Anhedonia Scale (SAS) illness- and personality-related variables. Correlation and regression analyses were performed.

Results: Three subgroups of patients were stratified by level of hedonic functioning: 52.9% passed the PAS and SAS cut-off ("double anhedonics"), 14.9% the PAS cut-off and 18.4% the SAS cut-off ("hypohedonics"), and 13.8% did not reach the PAS or SAS cut-off ("normal hedonics"). Increased negative and emotional distress symptoms together with low levels of task-oriented and avoidance-coping styles, self-efficacy, and social support were significantly correlated with PAS/SAS scores. Multivariate regression analysis indicated that the contribution of illness-related predictors was 4.1% to the variance of PAS and 5.5% to SAS scores, whereas the contribution of personality-related predictors was 24.1% for PAS and 14.1% for SAS scores. The predictive value of negative symptoms did not reach significant levels.

Conclusions: The hedonic functioning of SZ/SA patients is attributed to a number of personality-related factors rather than to state-dependent clinical symptoms. These findings enable better understanding of the multifactorial nature of anhedonia and might be of therapeutic relevance.