Mathata a ho lemalla, Anhedonia le Comodbid Mood Disorder. Tlhahlobo e Khutšoanyane (2019)

Front Psychiatry. 2019; 10: 311.

E hatisitsoe Inthaneteng 2019 May 22. doi: 10.3389 / fpsyt.2019.00311

PMCID: PMC6538808

PMID: 31178763

Marianne Destoop, 1, 2 Manuel Morrens, 1, 3 Violette Coppens, 1, 3 'me Geert Dom 1, 2, *

inahaneloang

Background: Haufinyane, anhedonia e 'nile ea amoheloa e le karolo ea bohlokoa ea lipatlisiso tsa Domain Criterion (RDoC) ke Setsi sa Naha sa Bophelo ba kelello. Anhedonia e khothalletsoa ho bapala karolo ea bohlokoa ho likokoana-hloko tsa mathata a lemallo le a maikutlo, mme mohlomong ho hlaha ha tsona le motho a le mong. Leha ho le joalo, ho fihlela joale, tlhaiso-leseling e phethahetseng ka anhedonia mabapi le methapo ea eona ea methapo ea kutlo, methapo ea kutlo ea kutlo, le karolo ea bona ea ho lemalla, bokuli ba maikutlo le bosoasoi e ntse e haella.

Sepheo: Thutong ena ea lingoliloeng tsa batho, re tlisa mmuso oa hona joale oa tsebo mabapi le anhedonia kamanong ea eona le mathata a ts'ebeliso ea lintho (DUS) le komello e nang le mathata a maikutlo.

Mokhoa: Patlisiso ea PubMed e ile ea etsoa ho sebelisoa mantsoe a latelang a lipatlisiso: (Anhedonia OR Reward Defence) LE ((Ho Ts'oaroa ha Dithethefatsi kapa Tlhekefetso) KAPA Tai Tloha kapa Nicotine KAPA KAHLOLOA KAPA HO BOTSA AU (Papali ea Marang-rang). Lingoloa tse mashome a mararo a metso e 'meli li kenyelelitsoe tlhahlobisong.

Results: Anhedonia e amahanngoa le mathata a tšebeliso ea lithethefatsi, 'me ho teba ha tsona ho hlahelletse haholo ho DUS e nang le khatello ea maikutlo ea comorbid. Anhedonia e kanna ea ba tšobotsi le bophahamo ba naha kamanong ea eona le DUS mme e hohela sephetho sa kalafo sa DUS hampe.

Keywords: anhedonia, mathata a ts'ebeliso ea lintho, tlhekefetso ea lithethefatsi, bokhoba ba maikutlo, khatello ea maikutlo, ho hloka taolo, ho becha, papali ea inthanete

Selelekela

Mathata a ts'ebeliso ea lintho (DUS) joalo ka ha ho hlalositsoe ke Buka ea Tlhahlobo le Tlaleho ea Phatlalatso ea Kelello-5 (DSM-5) ke mafu a hlasetsoeng haholo a nang le tšusumetso e mpe e kholo ho batho ka bomong, malapa a bona, le sechabeng ka kakaretso). Ho tsoa ho pono ea methapo ea kutlo, DUS e ka hlalosoa e le mathata a rarahaneng, ke hore, lihlopha tse ngata tsa matšoao le liserekisi tsa tsamaiso ea methapo ea kutlo li bapala karolo. Bohareng ba eona ho ne ho e-na le hypersensitivity ea susumetso e amanang le lithethefatsi le ho senyeha ho (Executive) taolong ea lits'usumetso tsena. Ka lehlakoreng le leng, ha kholo ea bokuli e ntse e tsoela pele, ho 'nile ha fanoa ka lehlakore le "lefifi" moo ho eketsoang keketseho ea khatello ea kelello, ho se mamelle khatello ea maikutlo, ho ama hampe, le ho anhedonia.).

Ho latela pono ea bongaka, anhedonia, ke hore, thahasello e fokotsehileng haholo kapa monyaka oa mesebetsi e khahlisang ka tlhaho, ke tšobotsi ea bohlokoa ho batho ba bangata ba lemaletseng. Matšoao a kang a Anhedonia a tlalehiloe molemong oa tšebeliso e mpe ea lithethefatsi, (ho sa feleng), le nakong ea ts'ebetso e sa khaotseng. Hape, anhedonia e ka etsa hore, ho batho ba bang, e nke e le ts'oaetso ea pele ea ts'ebetso ea litheko, ts'ebeliso e tloaelehileng, le phetoho ea morao-rao ea ho lemalla.). Matšoao a anhedonia a ka bontša liphetoho tse tlisoang ke methapo ea kutlo, hangata e amanang le "lehlakore le lefifi" la ho lemalla, moo ts'ebeliso e mpe ea ts'ebeliso ea lithethefatsi le setšoantšo sa neurochemical se laoloang ke ho hlohlona ha lits'ebetso tsa khatello ea kelello (). Tsena li ka kenyelletsa lits'ebetso tsa ts'oaetso ea peripheric tse tlalehiloeng molemong oa ts'ebeliso ea lithethefatsi tse sa foleng le tse amanang le khatello ea maikutlo le anhedonia (). Tumellanong le sena ke lipatlisiso tsa morao-rao tse bonts'ang hore li-antidepressants, e leng, agomelatine, li ka ama anhedonia, mohlomong dessyecik ho fokotseha protheine ea C e sebetsang le ho eketsa li-serum tsa BDNF (-). Ho feta moo, anhedonia e kanna ea ba le bohlokoa bo ikhethang ba kliniki, e leng, bakeng sa sephetho le karabelo ea kalafo. Ka sebele, anhedonia e eketsa monyetla oa ho oela hape mme e amana le ho lakatsa ().

Tšoaetso ea DUS ke ho ata ha comorbidity le mafu a mang a kelello. Sena e kanna ea ba sephetho sa tlhahlobo ea tlhaho ea lefutso ho tsoa lits'ebetsong tse fumanehang tsa tlhahlobo ea methapo tse kang DSM le ICD. Ntle le moo, mabaka a tloaelehileng a ka tsamaisa litlatsetso tse fapaneng tsa boits'oaro tseo ha ho fumanoe hore li "hlophisitsoe" maemong a boitšoaro li fella ka lipalo tse phahameng tsa lipalo). Mathata a maikutlo (MD) ke a mang a mathata a kelello ao ho tlalehiloeng hore a etsahetse khafetsa le DUS ke mathata a maikutlo (MD). Ho ba teng ha MD le DUS ho thehiloe hantle ka keketseho e habeli ho isa ho e mehlano ea menahano ea ho ba le MD ha boemo bo bong bo le teng.). Mabapi le pathogenesis ea maloetse a kelello, anhedonia e nkuoe e le sehlooho, sebopeho sa transdiagnostic, kahare ho khopolo ea phenotypic ea likhathatso tse fapaneng tsa kelello, mohlala, khatello ea maikutlo, schizophrenia, hape le DUS (). Boithuto ba morao-rao bo bonts'a hore moputso oa hyposensitivity kahare ho khatello ea maikutlo e sa amaneng le letho o tla amahanngoa ka matla le boemo ba anhedonia e khetholloang ke bofokoli bo susumetsoang khahlanong le hedonic (, ). Ho latela pono ena, ho ka nahanoa hore anhedonia e le sesosa sa ts'ebetso ea methapo ea kutlo e sebetsa e le mokhanni ea hlalosang ho ata ha maikutlo a khatello ea maikutlo ea DUS-khatello ea maikutlo. Ntle le moo, anhedonia e ka ba lets'oao kahare ho mathata a mabeli empa eo e simolohileng ho eona e thehiloe holima litsela tse fapaneng tsa pathogenetic, mohlala, anhedonia ka lebaka la taolo e tlase ea meputso tseleng ha motho a sebelisa ts'ebeliso e mpe ea maemo a teng (ab).

Anhedonia hase eona feela ntho e tloaelehileng e pakeng tsa DUS le mafu a mang a kelello. Ka 'nete, ho sebelisa poleloana ea lipatlisiso tsa Domain Criterion (RDoC), bofokoli lits'ebetsong tse amanang le ts'okelo (Negative Valence Systems), taolo ea molaoli (Arousal / Regulatory Systems), le memory memory (Cognitive Systems) e bonoa ho pholletsa le mathata a mangata a kelello " sebopeho se kahare ”(mohlala, khatello ea maikutlo, ho tšoenyeha) le sebono se“ kantle ”, mohlala, DUS (, ). Leha ho le joalo, ho tla fihlela joale, karolo ea anhedonia lithutong tsa bokhoba le boteng ba maikutlo le maikutlo a feto-fetohang maikutlong e se e sa laoloe haholo. Ena ke lehaha la bohlokoa kaha palo e ntseng e eketseha ea lithuto e bonts'a hore anhedonia, mohlala, maemong a khatello ea maikutlo, ke ntlha e mpe e hlahisang sephetho sa kalafo. Ha e le hantle, anhedonia e bolela esale pele hore bophelo ba nako e telele bo sa bonahaleng ba matšoao a khatello e kholo ea maikutlo, ho ipolaea, le maikutlo a ho ipolaea le karabelo e mpe kalafong ea meriana-).

Bophelong ba tlhahlobo ena, re qala ka ho hlahisa mehopolo mabapi le conceptualizing le ho hlahloba anhedonia. Ka mor'a moo, re hlahloba lingoliloeng tse lekolang kamano pakeng tsa anhedonia le mathata a ts'ebeliso ea lithethefatsi. Puisanong, re fetisetsa ka moo lintho tse fumanoeng li lumellanang le maikutlo a hona joale ho anhedonia le kamoo, ka mokhoa o ikhethileng, o ka nahanang ka kalafo le lipatlisiso tsa nako e tlang.

Conceptualization of Anhedonia

Anhedonia e bolela thahasello e fokotsehileng kapa monyaka oa ho araba maikutlo a tlhaho kapa ao pele a nkoang e le o khotsofatsang. Kahoo, anhedonia e amahanngoa ka tlhaho le ts'ebetso ea moputso. Ts'ebetso ea moputso e kenyelletsa likarolo tse ngata tse ka qhekelloang ka tlhahlobo mefuteng ea liphoofolo empa li ka hokahana maemong a nnete a bophelo: ho ts'oaroa ha maikutlo a ho susumetsa, ts'usumetso ea hedonic, thabo ka boeona (ho rata), tšusumetso ea ho fumana moputso le ho e sebeletsa (ho batla) kapa ts'usumetso ea ts'usumetso), le lits'ebetso tse amanang le ho ithuta tse amanang le moputso ().

Bonyane likarolo tse peli tse pharalletseng tse ka tlase ho anhedonia li fumanoe ka lipatlisiso tsa liphoofolo le batho: 1) moputso oa hyposensitivity le 2) mokhoa o fokolitsoeng oa tšusumetso. Habohlokoa, likarolo tsena ka bobeli li ka qhekelloa mabapi le tsela ea bona ea methapo le methapo ea kutlo ().

Reward hyposensitivity e khothalelitsoe ho amahanngoa le tšebetso e amanang le karolo ea "compummatory" ea ts'ebetso ea moputso, ke hore, hangata e hlahisoang ke polelo "ho rata." Pleasure ea tlhahiso e khothaletsoa hore e kopantsoe le tsela ea "endo native opioid" le "endocannabinoid receptor" ka tsela tse fapaneng. libaka tsa bokong (). Karolo ena e ka bitsoa bophahamo ba hedonic ea anhedonia, ke hore, "hedonic anhedonia."

Khothatso e atamelang e talingoa e le mokhanni ea nolofalletsang mokhoa kapa mokhoa o tataisoang ke sepheo ho fumana meputso. Tlhahisoleseling e kentsoeng ke phetisetso ea dopaminergic kahare ho sisteme ea mesolimbic e khothalletsoa ho bapala karolo ea moputso oa bohlokoa oa ho susumetsa le boikemisetso ba ho susumetsa (). Sistimi ea mantlha e khothalletsoa hore e be lisekele tsa dopaminergic frontostriatal. Ho fokotsa ts'ebetso ea dopaminergic ho na le phello e mpe khothatsong ea ho lelekisa le ho sebeletsa ho khothatsa ka mokhoa o khotsofatsang. Bophahamo bona bo ka bitsoa karolo ea susumetsang ea anhedonia, ho re, "anhedonia e susumetsang." Ka lehlohonolo, tsamaiso ea dopamine agonist (d-amfetamine) e hlahisa keketseho ea boikemisetso ba ho sebeletsa moputso mefuteng ea liphoofolo (, ).

Ha re e nka hammoho, bopaki bo ntseng bo hola bo tsoang ho boithuto, lithutong tsa boits'oaro, le thuto ea methapo ea kutlo bo bontša hore moputso oa ho ferekanya kelello le tšusumetso ea mokhoa o fokotsehileng o bonts'a anhedonia (). Ho latela pono ena, li-circuits tse peli tse ikhethileng tsa neural tse thehiloeng ho ts'usumetso (tebello, ho batla; joalo-joalo, tse amanang le dopamine ho supa kahare ho potoloho ea pele) le hedonic (tšebeliso, ho rata; joalo-joalo, e amanang le endo native opioids signaling) linaha tse amanang le moputso li ka fetisoa ka maikutlo (). Bakeng sa tlhahlobo ena, re nyalanya anhedonia ho tsena tse peli tsa motheo ( Setšoantšo sa 1 ).

Faele e kantle e ts'oereng setšoantšo, papiso, jj. Lebitso la ntho ke fpsyt-10-00311-g001.jpg

Bophahamo ba Anhedonia (, ).

Tlhahlobo: Sepheo le lipotso

Bophelong ba karolo ena ea tlhahlobo e hlalosang le e phetoang ea buka ena e ngotsoeng ka letsoho, re ikemiselitse ho hlahloba lipotso tse latelang.

  • Haholo ea anhedonia ho batho ba DUS ke efe?

  • Mefuta efe ea lisebelisoa tsa anhedonia e sebelisoang lithutong tsa batho ka har'a disampole tsa DUS?

  • Na ho na le phapang ho ea ka hedonic dhidi ea anhedonia ea hedonic?

  • Anhedonia e amana joang le DUS le khatello ea maikutlo?

  • Karolo ea anhedonia ke efe tseleng ea DUS le karabelo ea kalafo?

Method

Tlhahlobo e hlophisitsoeng ea morao-rao mabapi le kamano pakeng tsa mathata a tšebeliso ea lithethefatsi (SUD) le anhedonia e hlahlobile lingoliloeng ho fihlela 23 May 2013 (). Kahoo, ka tlhahlobo ena, re ikemiselitse ho holisa sehlopha sena sa mosebetsi ka ho hlahloba lingoliloeng tse phatlalalitsoeng kamora letsatsi lena, ke ho re, lilemo tse fetileng tsa 5. Patlo e entsoe ho PubMed sebelisa mantsoe a tšoanang a ho secha joalo ka phatlalatso ena ea morao-rao (). Re kenyelelitse papali ea chelete ea ho becha le lipapali tsa marang-rang patong ena hobane li sa tsoa kenyellelitsoe khaolong ea DUS ea DSM-5 (hape e tla ba ho ICD11 e latelang) e le mathata a lemalloang.

Bakeng sa ho fumana lithuto tsa mantlha tse batlisisang khokahano lipakeng tsa anhedonia le DUS, patlisiso ea PubMed (Mots'eanong oa 2013 – Pulungoana ea 2018) bakeng sa lingoloa tsa puo ea Senyesemane li ile tsa etsoa ho sebelisoa mantsoe a latelang a ho batla: (Anhedonia OR Reward Defence) LE ((Ho Tloha ha Dithethefatsi Kapa Tlhekefetso) KAPA Tai ea Tai Joala kapa Nikotine KAPA Ho Kena TSOHLE KAPA Ho Becha kapa ho becha ka Marang-rang). Lipampiri li ne li hlophiselitsoe lithuto tsa batho feela. Kakaretso ea ts'ebetso ea ho kenyelletsa e ka fumanoa ho Setšoantšo sa 2 . Patlo ea PubMed e hlahisitse liphetho tsa 171; Ho hlahlobisisoa ha litšoantšo ho lebisitse ho khethollotsoeng ha lipampiri tsa 136, li siea lipampiri tsa 35. Ho tsena, pampiri e le 'ngoe e felletseng e ne e sa khone ho fumanoa hape,' me lithuto tse peli tsa netefatso ha lia ka tsa kenyelletsoa, ​​kahoo lingoloa tsa 32 li kenyelelitsoe tlhahlobisong.

Faele e kantle e ts'oereng setšoantšo, papiso, jj. Lebitso la ntho ke fpsyt-10-00311-g002.jpg

Leano la ho batla lipampiri tsa lipatlisiso ho PubMed.

Results

Boholo ba lithuto (n = 13) e shebane le ho tsuba koae ha ho bapisoa le joala (n = 4), cannabis (n = 4), koaen = 5), li-benzodiazepines (n = 1), le li-opioids (n = 4). Batho ba lemaletseng boitšoaro bo bobe ba lula ba sa ithute hantle, e leng thuto e le 'ngoe ka papali ea chelete,' me ha ho e 'ngoe lipapatsong tsa inthanete. Bona Lethathamo 1 bakeng sa kakaretso ea lithuto tsohle.

Lethathamo 1

Liphetho ho tsoa tlhahlobisong ea lingoliloeng.

MongolisampoleTekanyo ea AnhedoniaHo itšoara hampePhello
IpheoMosebetsi oa boitšoaroNeuro-biologic
ho noa joala()MDD (n = 4,339)
MDD + AUD (n = 413)		MINI//MDDAnhedonia e amahanngoa le botahoa
()Barekisi ba sesole ba tsoang sesoleng ba United States (n = 913)PCL-5//Matšoao a PTSDAnhedonia e amanang le litlamorao tsa joala tsa selemo se fetileng
()18- ho 25 ea selemo sa Spain batho ba baholo ba hlahang (n = 181)CES-D///Maemo a phahameng a anhedonia a ne a amahanngoa le ho teba ha tšebeliso ea joala
()Baithuti ba koleche (lilemo tsa 18-22) (n = 820)MASQ-SF/fMRI ha barupeluoa ba qetile mosebetsi oa ho nahana ka karete, o phahamisang ho etsa mosebetsi oa nakoana/Ho fokotseha hoa ts'ebetso ea "ventral striatum" ho amanang le moputso ho amana le kotsi e kholo ea anhedonia ho batho ba pepesetsoeng khatello ea maikutlo bophelong. Anhedonia e joalo e amanang le khatello ea maikutlo e amahanngoa le tšebeliso e mpe ea joala
Nicotine()Ba tsubang lisakerete tse seng letsatsi le leng le le leng (lilemo tsa 18-24) (n = 518): ho tsuba ho feta 1 / m ho feta 6mSHAPS marang-rang kamora ho latela ha 3, 6, le 9 likhoeli tse latelang///Anhedonia ha e no rere bakeng sa ts'ebeliso ea lihlahisoa tse ling tsa koae (OTP), empa tse nang le anhedonia e sebelisang hookah khafetsa
(Batho ba baholo tekong ea tleliniking ea ho tlohela ho tsuba (n = 1,122), min 10 sig / d min 6 m: placebo (n = 131), bupropion (n = 401), kapa NRT (n = 590)Liteko tsa nakoana tsa tlhaho ea 4 ka letsatsi 5 matsatsi a pele le matsatsi a 10 kamora letsatsi la ho tlohela///Anhedonia e amana le ho its'epa 'me e hatelloa ke tsamaiso ea agonist
()Baithuti ba sehlopha sa borobong (13-15 lilemo)n = 3299): ba sa tsubang (n = 343), ha ho mohla batho ba tsubang (n = 2,956)SHAPS///Anhedonia e amahanngoa le ho qala ho tsuba ho sampole ka kakaretso le ho ba le ts'ebeliso e phahameng ea bophelo ba batho ba sa tsubeng.
()Ba tsubang ba sa batleng kalafo (ho feta 10 sig / d, ho feta lilemo tsa 2) (n = 125) ho ea litekong tsa liteko tsa 2 tse hanyetsanang le liteko (tse thibelang (bakeng sa 16 h) vs. leha e le ngoe e thibeloang)SHAPSMosebetsi oa Boemo ba Litšoantšo//Anhedonia e kholo e amanang le ho kopana hape ho sa nepahalang ha litšoantšo tse mpe
()Ho tsuba litho tsa teko ea tleliniking ea mahlo a mabeli e sa boneng mahlo (n = 1,236): nicotine patchn = 216), nicotine lozenge (n = 211), bupropion (n = 213), patch + lozenge (n = 228), bupropion + lozenge (n = 221), placebo (n = 147)Liteko tsa nakoana tsa tlhaho ea 4 ka letsatsi 5 matsatsi a pele le matsatsi a 10 kamora letsatsi la ho tlohela///Sehlopha se phahameng sa takatso ea anhedonia se tlalehileng ho its'epaha ho phahameng, se na monyetla oa ho fumana phetisetso ea motsoako oa nicotine, ho tlalehiloe hore litekanyetso tsa ho tlohela beke tsa 8 li ile tsa khutla mme tsa khutla haufinyane
()Mosi (ho feta 5 sig / d) (n = 1125)MASQ-S///Ho potlaka ho amana le ho tsuba ka tekanyo e phahameng kapa e phahameng ea anhedonia; e ne e sa amane le ho tsuba ha matšoao a anhedonia a fokolang a ile a lumelloa
()Batho ba baholo ba tsubang (n = 525) (ho feta 10 / d) ho tsoa teko ea bongaka ea ho khaotsa ho phekolo ea 21 mg / letsatsi nicotine patch nakong ea libeke tsa 8SHAPS///Barupeluoa ba 70 (13%) e ne e le anhedonic, banna ba ne ba le anhedonic haholo, batho ba tsubang ba anhedonic ba ne ba ka thibeloa habonolo
()Baithuti ba sehlopha sa borobong (n = 807):
294 ha e na nalane ea SUD, nalane ea bophelo ba 166 ea tšebeliso ea lithethefatsi / joala ntle le koae, nalane ea bophelo ba 115 ea tšebeliso ea lithethefatsi / joala ka koae		SHAPS///Bacha ba nang le tahi ea bophelo bohle / tšebeliso ea lithethefatsi ntle le koae ba ne ba e-na le bothata bo phahameng
()Baithuti ba sehlopha sa borobong (n = 3,310): 2,557 ha e tsubelle kapa e-koae, X -UMX e-koae feela, 412 koae e tloaelehileng, 152 e tloaelehileng le e-koaeSHAPS///Anhedonia e ne e phahame ho e-koae feela ha e sa sebelisoe ke basebelisi. Phello e laetsoeng ea ts'ebeliso e 'meli ea tšebeliso ea koae e - koae feela le - e sa sebelisoeng e fumanoe anhedonia
()Li-Veterans tse nang le MDD kapa dysthymia (n = 80): Batho ba tsubang ba nang le khatello ea maikutlo ba 36 le 44 ba tepelletseng bao e seng batho ba tsubangMASQ-S
BIS / BAS		Mosebetsi oa moputso oa probabilistic o lekanyang ho ithuta ka moputso/MDD-dysthymiaBa tsubang ba sithabetsang maikutlo ba tlalehile litheko tse phahameng tsa boitšoaro 'me ba fokotsa boikarabello ba moputso oa BAS ha bo bapisoa le ba sa tsubeng. Batho ba nang le khatello ea maikutlo ba ile ba bontša hore ba ne ba fumane moputso o eketsehileng oa ho ithuta ka moputso
()Batho ba baholo ba tsoang ho teko ea tleliniking ea ho tlohela ho tsuba (n = 1,175) (min 10 sig / d likhoeli tse fetileng tsa 6): lupropion, nicotine lozenge, nicotine patch + lozenge, bupropion + nicotine lozenge kapa placeboLiteko tsa nakoana tsa tlhaho tsa 4 ka letsatsi ho tloha matsatsing a 5 pele ho matsatsi a 10 kamora letsatsi la ho tlohela///Anhedonia e bonts'itse mokhoa o khelohileng oa phetoho e arabelang ho tsibollo ea koae mme o hokahana le ho teba ha matšoao a bang teng ha motho a khaotsa ho tsuba. Anhedonia ea ho tlohela mosebetsi e ne e amahanngoa le ho fokotseha hoa morao-rao hore motho a boele a ts'oare hape ka lebaka la ho khaotsa ho ts'oaetso ha beke ea 8. NRT e hatelletse keketseho ea anhedonia e amanang le litšila
()Batho ba baholo ba hotsoe dessyecik liphatlalatso (n = 275) (ho feta 10 sig / d): barupeluoa ba ile ketelong ea mantlha e neng e kenyelletsa anhedonia e lateloang ke maeto a khahlanong le 2 kamora ho tsuba ha 16 h ho tsuba le ho se thibele.SHS
TSIETSI
Cai		Mosebetsi oa ho tsuba o lekanyang moputso oa boleng ba ho tsuba//Ahedonia e phahameng e boletse esale pele ho qala ho tsuba kapele le ho tsuba lisakarete tse ngata, tse arolelanoang ka mokhoa o fokolang ke libaka tse bobebe tse phahameng. Ho ila boitšoaro ho ile ha phahamisa tekanyo eo anhedonia e boletseng pele ho tsuba koae har'a ba arabelang ho eona ka ho qhekella, empa eseng mohlala oohle
()Batho ba tsubang ba ngolisitse thutong ea kalafo ea ho tlohela ho tsuba (n = 1,469) (ho feta 10 sig / d ho feta 6 m): lupropion (n = 264), nicotine lozenge (n = 260), nicotine patchn = 262), bupropion + lozenge (n = 262), placebo (n = 189)Life time anhedonia dessyecik CIDI//ho tepella maikutlong honaAnhedonia e boletse esale pele phello ea ho khaotsa
Cannabis()Basebelisi ba cannabis pakeng tsa 15 le 24 lilemo (n = 162): Qaleho ea pejana ea 47, pele ho lilemo tsa 16; Qaleho ea morao ea 115Online OLIFE//SchizotypyTšebeliso ea cannabis ea pele ho nako e amana le maemo a phahameng a anhedonia ho basali feela
()Moithuti lilemong tsa 14 (n = 3,394) ho latela basel, 6-, 12-, le 18 ea ho latela khoeliSHAPS///Anhedonia e amana le tšebeliso ea morao-rao ea tšebeliso ea matekoane e ntlafalitsoeng ke metsoalle e sebelisang cannabis, empa ts'ebeliso ea mantlha ea tšebeliso ea matekoane ha e amana le sekhahla sa phetoho ea anhedonia.
()Banna ba lilemo li 20n = 158), e hiriloe a le lilemo li 6-17 mSHAPS/fMRI nakong ea papali ea ha karete ea 24 e lekang nyeoe butle-butle e lekang karabelo ho lebella le ho fumana moputso oa cheleteSehlopha se ntseng se eketseha sa maemo a phahameng se bonts'itse mokhoa oa khokahano e mpe ea NAcc-mPFC e neng e hokahane le maemo a holimo a anhedonia
()Sehlopha sa MDD se tsoang liphuputsong tsa naha (n = 2,348): basebelisi ba nang le basebelisi ba CUD vs. ntle le CUDDSM-IV mekgwatiriso//MDDBoemo ba tšebeliso ea cannabis bo amahanngoa le anhedonia
Litšusumetso()Batho ba baholo ba batlang kalafo ba itšetlehileng ka koae: ho tsamaiso ea maemo a tšohanyetso (n = 85): 40 placebo, 45 levodopaSHAPSMosebetsi oa PR//L-dopa ha ea ka ea ntlafatsa sephetho sa CM, ebile phello ha e ea ka ea emisoa ke anhedonia; anhedonia e ka ba phapang e ikhethileng e amanang le sephetho sa mafu a CM
()Barupeluoa ba CUD (n = 46)CSSA/RewP ea ERP/RewP e hokahane le anhedonia, 'me anhedonia e hlalositse phapang e kholo phapang ea RewP
()Ba hlekefetsang ba bang ka koae hona joale (n = 23) le bankakarolo ba se nang nalane ea lithethefatsi (n = 24)SHAPS/ERP kamora ho amohela moputso/Anhedonia e amahanngoa le tšusumetso ea moputso, tlhaiso e fokolitsoeng ea moputso, le tlhaiso e fokolisitsoeng ea tlhaiso
()Ba hlekefetsang hona joale ba koae,n = 23) mme e laola ntle le nalane ea lithethefatsi (n = 27)SHAPS
CPCSAS		/Mosebetsi oa Go / NoGo ha EEG e ntse e rekotoa. Litšoantšo tse hlakileng tse tsoang ho International Affective Picture System/Basebelisi ba cocaine ba sebelitse hampe haholo ho feta taolo mosebetsing oa taolo ea thibelo. Basebelisi ba Cocaine ba ne ba anhedonic haholoanyane. Maemo a phahameng a anhedonia a ne a amahanngoa le tšebeliso e matla ea lithethefatsi. Taolo ea inhibitor le anhedonia li ne li ikamahanya feela le taolo
()Bakuli ba itšetlehileng ka cocoaine, ba lokolohileng ho koae ka libeke tsa 3 tsa ho qetela (n = 23) le li-control tse nang le phepo e ntle (n = 38)Sekala sa Chapman psychosis-expression (se nang le anhedonia e ntlafalitsoeng ea 'mele le ntlafatso ea anhedonia ea sechaba)/Paradigm e sebelisang matla a kopantsoeng ho tsosa likarabo tse tharo tsa bohareng ba morao-rao tse ileng tsa tsosa likarabo (MLAER), e leng, P50, N100, le P200Polelo ea PsychosisLikolo tsa anhedonia tsa sechaba li ikarabella bakeng sa karohano e kholo ka ho fetisisa ea makhopho a P200. Ho fufuleloa ha P50 ea mafutsana ho amana le palo e phahameng ea boemo ba anhedonia sechabeng taolong e phetseng hantle le ka mefuta eohle e tsoakaneng ea bakuli ba itšebelitseng koae
Li-opioids()Barupeluoa ba itšetlehileng ka heroin mabapi le tlhokomelo ea opioid (n = 90): ho methadone (n = 55) kapa ho buprenorphine (n = 35); mme ba sa tsoa amohela letho (ho fihlela likhoeli tsa 12) barupeluoa ba sebelisang opioidn = 31);
le taolo e phetseng hantle (n = 33)		SHAPS
TSIETSI		///Ho phahama ho anhedonia ho barupeluoa ba itšetlehileng ka opioid
()Bakuli (haholo-holo liphokojoe) ba itšetlehileng ka opioid (n = 306): 1,000 mg naltrexone implant + molomo oa placebo (n = 102), implant ea placebo le 50 mg naltrexone ea molomo (n = 102), placebo ka bobelin = 102)FAS
CSPSA		///Anhedonia e ile ea phahamisoa motheong oa motheo 'me ea fokotsoa hore e tloaelehe nakong ea likhoeli tsa pele tsa 1-2 bakeng sa bakuli ba ileng ba lula kalafong mme ba sa boele, ho se be le phapang lipakeng tsa lihlopha
()Bakuli ba ts'ehetsoang ke opioid 10-14 matsatsi a le mong ka mor'a ho tlohela (PODP) (n = 36) le li-control tse nang le phepo e ntle (n = 10)SHAPSKarabo e makatsang e hlophisitsoeng e hlophisitsoeng (AMSR)Mosebetsi oa ho etsa mesebetsi ea bocha nakong eo RPFC le RLFFC e neng e nka karolo e ne e beiloe leihlo ka pono e sebetsang haufi le infrared/PODP e tlaleha ts'ebetso e kholo ho tlalehong ea boits'oaro, e fokotse karabelo ea hedonic ho tse khothatsang mosebetsing oa AMSR, ea fokotsa RPFC e kopaneng mme ea tlohela mosebetsi oa VLPFC ho ea litšoantšong tsa lijo mme a fokotsa VLPFC maemong a monate sechabeng ha a bapisoa le taolo. Bakuli ba nang le anhedonia ba bontšitse karabelo e fokotsehileng lithutong tse ntle tsa sechaba le lijo
()Bakuli ba itšetlehileng ka heroin ba hapiloeng libakeng tsa kalafo ea bokhoba ba tahi (n = 12) Libeke tsa 2 kamora libeke tse qalang ho lokolloa ka morao-rao naltrexone (XRNT) le lithuto tse phetseng hantle (n = 11)SHAPS/[123I] FP-CIT SPECT-scanning ea liteko tsa liteko tsa li-DAT tse tlamang: 1 pele le 1 2 libeke kamora ho kenngoa ka XRNT/XRNT ha e ame anhedonia, empa ka phokotso e kholo ea matšoao a sithabetsang
becha()Lipalesa tse nang le lefu la Parkinson (n = 154): 34 e phethisitse mekhoa ea lefu la taolo ea ts'usumetso (ICD), eo 11 e ileng ea kopana le mekhoa ea papali ea ts'ebeliso ea methapo ea methapo (PG)SHAPS//Lefu la ParkinsonPG e bile le bothata bo phahameng ba anhedonia
Papali ea Inthanete//////
Benzodiazepines()Liphetho tsa MDD tsa database tsa MDPU (Setsi sa Mood Disorder Psychopharmacology) (n = 326): Basebelisi ba li-benzodiazepine tsa 79, basebelisi ba 247 ba nonbenzodiazepineMAHALA//MDDAnhedonia e ne e le kholo sehlopheng sa benzodiazepine, 'me anhedonia e ne e le moetapele ea matla oa tšebeliso ea kamehla ea benzodiazepine

OLIFE, Oxford-125 Liverpool Lethathamo la Maikutlo le Liphihlelo; PCL-5 = Lethathamo la PTSD la DSM-5; SHAPS, Snaith-Hamilton Pleasure Scale; TEPS, Boiphihlelo ba nakoana ba Pleasure Scale; REI, Melemo ea Lipapatso e Fumanehang; CES-D, Center Epidemiological Study Depression Scale; Mosebetsi oa PR, mosebetsi oa karo-karo e tsoelang pele; FAS, Ferguson Anhedonia Scale; CSPSA, Chapman Scale ea anhedonia ea 'mele le ea Bohlokoa; MASQ-S, Foromo ea Mood le Matšoenyeho a Matšoao a ho Tšoenyeha ha Matšoao a Khutšoanyane (ka subscale ea Anhedonic Depression); CSSA, Cocaine Selection Severity Tlhahlobo ea Tekano; RewP, Karolo ea Reward Positivity; TEPS, Boiphihlelo ba nakoana ba Pleasure Scale; BIS / BAS, Behavioral Inhibition / Behaeveal activation Scale; CPCSAS, Chapman Physical and Chapman Social Anhedonia Scales; SHS, Sekala sa thabo ea Subjective; CAI, Anhedonia Index ea Composite; MINI, Mini International Neuropsychiatric Puisano; CIDI, Puisano ea Tlhaho ea Machaba e Kopaneng; MADRS, Montgomery-Asberg Depression Rating Scale.

Mefuta ea Mehato ea Anhedonia e Sebelisoang kahare ho lithuto tsa DUS

Mehato ea ho itlaleha e ne e le lisebelisoa tse sebelisoang haholo, ke hore, lithuto tsohle li kenyeletsa mehato ea ho itlaleha. Ho tsena, Snaith-Hamilton Pleasure Scale (SHAPS) () e ne e sebelisoa khafetsa, ke hore, ho 15 ea lithuto tsa 32. Ka har'a lipatlisiso tsa khatello ea maikutlo, SHAPS e netefalitsoe 'me e ntse e le setsi sa khauta. E lekanya thabo e khotsofatsang () hangata. Leha ho le joalo, ha ho fanoa ka khothatso ea hore tekanyo efe kapa efe e lokela ho netefatsoa ho palo ea batho ba nang le phaello pele ba e sebelisa, ho tlameha ho hlokomeloe hore ha ho le e 'ngoe ea likala tsa ho itlaleha tse fumanoeng tlhahlobisong ena e kileng ea netefatsoa hara palo ea batho ba DUS. Sena se tiisa hore ho hlalosoa liphetho tsa hajoale.

Ho khahlisang, lithuto tse tharo li sebelisitse liteko tsa nakoana tsa tikoloho (EMAs) ka makhetlo a mane ka letsatsi tekong ea ho tlohela ho tsuba (, , ). Ho ile ha botsoa hore na barupeluoa ba bile le thabo e kae motšehare literekeng tse tharo (boiketlo ba sechaba, boikhathollo le tšebetso). EMA e kanna ea ba mokhoa o ts'episang o fanang ka datha e koahelang ho iphetola ha matšoao ho feta (ho itlhahisa) tlaleho mme o sebelisoa haholo lithutong tsa khatello ea maikutlo le bokhoba (, ). Leha ho le joalo, hajoale, ha ho na setsi se netefalitsoeng sa lipotso tse ka hlahisoang ke EMA ka anhedonia.

Liphuputso tse fokolang (n = 4) o sebelisitse mesebetsi ea boits'oaro. Guillot et al. o sebelisitse Teko ea Litekanyetso tsa setšoantšo, e leng tekanyo ea menyenyetsi e amanang le likeletso tse ntle, tse mpe, le ho tsuba (). Mosebetsing ona, barupeluoa ba ile ba laeloa ho lekanya monate oa khothalletso e 'ngoe le e' ngoe ka ho tobetsa linotlolo tse tsamaellanang le lintlha tse supileng tsa Likert ho tloha −3 (e sa thabiseng haholo) ho 3 (e monate haholo). Ho bontšoa litšoantšo tse ntle, tse mpe, tse tsubang le tse sa nkeng lehlakore. Mosebetsing ona, anhedonia e 'nile ea amahanngoa le maikutlo a monate a tšusumetso e ntle kapa e amanang le moputso.

Eleantant et al. () o sebelisitse mosebetsi oa ho khetholla matšoao a reretsoeng ho lekola modumo ea boitšoaro ho arabela meputso, e neng e se e sebelisoa liteko le MDD le mathata a ho ferekana (). Lithutong tsa morao-rao, kamano e fapaneng pakeng tsa khethollo le anhedonia e se e bontšitsoe.

Leventhal et al. sebelisa ts'ebetso ea boits'oaro e lekanyang boleng ba moputso o lekanang le oa ho tsuba (). Mosebetsi ona o hlahisa mekhoa ea boits'oaro ea boleng bo lekanang ba) ho qala ho tsuba khahlanong le ho lieha ho tsuba bakeng sa chelete le b) Ho itšebella koae ka chelete ha o fuoa monyetla oa ho tsuba.

Wardle et al. o sebelisitse mokhoa o tsoelang pele oa karo-karolelano e le mokhoa oa boitšoaro oa anhedonia (). Barupeluoa ba ka khetha likhetho tse peli tseo khetho e ka hlahisang meputso e meholo ka phapanyetsano ea boiteko bo boholo ha khetho ea C e tlisa moputso o fokolang empa e hloka boiteko bo fokolang. Likhatiso tse fokolang tsa konopo tsa A li bonts'a anhedonia e susumetsang. Ho tlameha ho hlokomeloe hore mofuta ona oa boits'oaro ha o amanang ka botlalo le SHAPS ().

Ha li kopantsoe hammoho, lithuto tsena tse 'ne li sebelisana le boits'oaro kaofela li sebelisitse paradigm e fapaneng. Ha ho ntse ho sa tsejoe hore na ba kopanya karolo efe kapa boholo ba anhedonia le hore na ba amana joang le anhedonia e itlalehileng.

Lithuto tse supileng li sebelisitse neurobiological, ke hore, methapo ea kutlo kapa ea ho nahana, mehato ea anhedonia. Taba ea pele, tlhahlobo e sebetsang ea matla a ts'ebetso ea matla a khoheli (fMRI) ho basebelisi ba banyenyane ba bang e sebelisitse papali ea likarete tse peli e ileng ea lekola karabelo ea ho lebella le ho fumana moputso oa chelete (). Paradigm ena, anhedonia e ne e amahanngoa le mokhoa oa khokahano e mpe oa Nucleus Accumbens (NAcc) -dial Prefrontal Cortex (mPFC).

Parvaz et al. o sebelisitse mosebetsi oa ho becha o bolela esale pele hore na ba tla hapa kapa ho lahleheloa ke chelete tekong e 'ngoe le e' ngoe, athe data ea ERP e hlokahala (). Karolo ea Reward Positivity (RewP) ha a araba liteko tse boletsoeng esale pele o ile a tlosoa ho ERP. RewP e amahanngoa le libaka tse tšoanang tsa boko le tsona tse amehang ho anhedonia (ke hore, ventral striatum le mPFC). Liphetho li bonts'itse hore bophahamo ba RewP ha bo arabela litekong tse fuoeng tse kopantsoeng le ho teba ha Ched.

Morie et al. o entse lithuto tse peli tsa ERP ho ba hlekefetsang koae le ho laola ka mokhoa o phetseng hantle (, ). Ho Morie et al. (), ho sebelisoa mosebetsi o potlakileng oa ho arabela o nang le menyetla e fapaneng ea moputso. Basebelisi ba Cocaine ba bonts'itse karabelo e sa nepahalang lithetleng tse lebisang moputsong le ho fana ka maikutlo mabapi le katleho ea mosebetsi kapa ho se atlehe. Anhedonia e lekantsoeng ke SHAPS e ne e boetse e amahanngoa le ho fokotseha ha leihlo le ho fumana moputso ho basebelisi ba koae. Mehato ea anhedonia e ne e amahanngoa le tšusumetso ea moputso ho basebelisi ba koae ka bobeli le taolo e phetseng hantle (). Morie et al. () o sebelisitse mosebetsi oa Go / NoGo ho arabela litšoantšo tse netefalitsoeng. Leha hona e le tekanyo e eketsehileng ea ts'ebetso ea botsamaisi, ke ho re, inhibition and monitoring performance, ho ile ha fumanoa khokahano pakeng tsa taolo ea inhibitory le anhedonia, empa e le taolong feela.

Ka sehlopha se senyenyane sa bakuli ba itšetlehileng ka li-heroin tse ts'ehetsoeng, striatal dopamine transporter binding e ile ea hlahlojoa ke [123I] FP-CIT single Photon emission computed tomography (SPECT) pele le libeke tsa 2 kamora ho kenngoa ka ente ka naltrexone e atolositsoeng (). Le ha matšoao a khatello ea maikutlo a ne a le holimo bakeng sa bakuli ba mantlha le matšoao a khatello ea maikutlo a ne a le tlase ka mor'a kalafo ea nako e telele ea naltrexone (XRNT), ha ho mekhatlo e ka fumanoang bakeng sa anhedonia.

Kamora nako, thuto e kholo ea fMRI le baithuti ba koleche ea 820 ba sebelisitse mosebetsi oa ho khutlisa oa stralatum, paradigm e koetsoeng, e nang le lithibelo tse tharo tsa karabelo e ntle, li-block tse tharo tsa maikutlo a fosahetseng, le lithibelo tse tharo tsa taolo (). Ho fokotseha hoa ts'ebetso ea "ventral striatum" ho amanang le moputso ho amana le kotsi e kholo ea anhedonia ho batho ba pepesetsoeng khatello ea maikutlo bophelong. Tšebelisano ena e hokahane le matšoao a mang a nyahamisang le tšebeliso e mpe ea tahi.

Phuputsong e le 'ngoe feela moo mehato e neng e kopanetsoe ea ho itlaleha, boitšoaro le ho ts'oaroana ha bohloko). Bakuli ba ts'ehetsang opioid ba mashome a mararo a metso e ts'eletseng le taolo e phetseng hantle ea 10 ba tlatsitsoe ho SHAPS mme ba etsa ts'ebetso ea ho qala e amang maikutlo (AMSR), tekanyo ea psychophysiological ea valence ea maikutlo, e neng e sebelisoa pele ho lekola likarabo tsa hedonic mabapi le tšusumetso e amanang le moputso. Ho ka hlahisoa mefuta e mene ea lintho tse khothatsang: tse ntle, tse mpe, tse sa nkeng lehlakore le tse amanang le lithethefatsi. Khabareng, litlatsetso tsa maiketsetso tsa maiketsetso li ile tsa hlahisoa libakeng tse fapaneng 'me karolo ea ho panya ha leihlo ea reflex Reflex e tlalehiloe ke EMG. Barupeluoa bohle ba ile ba tlatsa paradigm e tloaelehileng ea pono ea ha ba ntse ba beiloe leihlo ka ts'ebetso e haufi le infrared spectroscopy (fNIRS). Stimuli e ne e le mekhahlelo e meraro e metle ea lijo tse matla (lijo tse fumanehang habonolo, tšebelisano e ntle ea setsoalle, le kamano e haufi-ufi) hammoho le tšusumetso ea maikutlo. Bakuli ba itšetlehileng ka opioid ba tlaleha ts'ebetso e kholo ho itlaleha, ba fokotsa karabelo ea hedonic ho tse khothatsang mosebetsing oa AMSR, mme ba fokotsa RPFC e kopaneng mme ba siea VLPFC e le sejo se bontšitsoeng le ho fokotsa VLPFC maemong a monate sechabeng ha a bapisoa le taolo.

Ba kopantsoe hammoho, leha lithuto tse ngata li sebelisitse tekanyo ea neurobiological ha li bapisoa le ts'ebetso ea boits'oaro feela, kaofela ha bona ba sebelisitse paradigm e fapaneng, ba etsa papiso ea liphetho ho le thata. Hape, e ntse e hlalosoa hore na likarolo le likarolo tsa anhedonia li hapiloe ke li-paradigms tsena tse fapaneng joang, leha lithuto tse ling li fana ka matšoao bakeng sa karolo ea sepheo sa tšusumetso (mohlala, khokahano ea fronto-striatal).

Anhedonia Ka har'a DUS Popula

Boithuto bo fokolang haholo bo bapisitse anhedonia pakeng tsa sampuli ea bakuli ba DUS ba nang le taolo eo e seng ea DUS. Boithuto bo bong bo ile ba shebisisa kamano e lipakeng tsa tlhekefetso ea lithethefatsi le ho fapana ho tebileng ho amanang le anhedonia mehlala ea batho ba DUS.

Lithuto tse nang le sehlopha sa taolo e phetseng hantle li bonts'itse khafetsa hore batho ba hlekefetsang koae, batho ba itšetlehileng ka heroine, le batho ba its'epileng ka benzodiazepine e ne e le taolo ea hanyetsano ea anhedonic. Hape, maemo a holimo a anhedonia a amanang le ts'ebeliso e matla ea lithethefatsi (, , , , ).

Boithuto kahare ho mehlala ea DUS ntle le taolo bo hlahisitse sephetho se ts'oanang; ie, anhedonia e ne e amahanngoa le mefuta ea tšebeliso ea lithethefatsi. Lithuto tse tharo mabapi le joala li bonts'itse kamano e ntle lipakeng tsa anhedonia le ts'ebeliso e mpe ea joala le litlamorao tse tsamaellanang (-). Ho batho ba tsubang koae, liphuputso tse ngata li fana ka sesupo sa hore ho na le phello e mpe ea ho tsuba: ho qala ho tsuba, ho tsuba le ho tsitsipana ((ho tsubella), , , ). Kamora nako, ts'imolohong ea tšebeliso ea matekoane, ho nyoloha ha tšebeliso ea matekoane le boemo ba tšebeliso li hokahane le maemo a holimo a "anhedonia", , ). Phuputso e 'ngoe mabapi le papali ea chelete e bontšitse maemo a phahameng a anhedonia lethathamong la papali ea chelete ea bakuli ba lefu la Parkinson (). Leha ho le joalo, thuto ena e kenyelletsa feela batšoaruoa ba 11, e lumellang ho hlalosoa ka hloko.

Ha re kopantsoe, lintho tse fapaneng, matšoao a lumellana a hore 1) batho ba DUS ba na le maemo a phahameng ho feta taolo le hore 2) anhedonia e ka amana le ho qala ha tšebeliso ea lithethefatsi le ho teba ha morao ha DUS.

Khosi ea Nako ea Anhedonia: Tsela kapa Naha?

Bakeng sa batho ba itšetlehang ka nicotine, ho na le bopaki ba hore anhedonia ke boemo le tšobotsi. Taba ea pele, thutong e telele le barupeluoa ba bacha ba 518, ho ba teng ha anhedonia ho ile ha bolela ts'ebeliso ea ts'ebetso ea "ora "). Bopaki ba anhedonia e le tšobotsi bo ka fumanoa le thutong ea Leventhal (), e seng e hlalositsoe ka holimo (). Batho ba tloaetseng ho tsuba ba ile ba bolela esale pele hore ho tla tsuba ho potlakileng le ho tsuba koae, 'me ho tsuba ho tsubang ha 16-h ho matlafalitse tekanyo eo anhedonia e boletseng ho tsuba koae ka eona. Ntle le moo, phuputso ea morao-rao e bonts'itse hore 1) anhedonia e amana le ho qala ho tsuba le bacha ba 2) ba lilemong tsa bocha ba nang le "anhedonia" ba sa kang ba leka ho tsuba ba ka ba le monyetla oa ho tsuba ho ka etsahala ka lebaka la sepheo se matla sa pro-ho tsuba kapa ho ikemisetsa ho tsuba ().

Lintlha tse tšehetsang tšobotsi ea anhedonia ea lintho tse ling li 'maloa. Bakeng sa cannabis, anhedonia e amahantsoe le ho qaleha ha tšebeliso ea matekoane le tšebeliso ea matekoane matlong a bocha (, ).

Ka lehlakoreng le leng, anhedonia e ka ba karolo ea ho khaotsa ho tsuba. Cook et al. () e bonts'itse mokhoa o iphetotseng oa U mabapi le ho khaotsa ho tsuba, o neng o amana le ho teba ha matšoao a bang). Thutong ea morao-rao ea khoeli ea 6 le bakuli ba itšetlehileng ka opioid (boholo ba li-inpatients), maemo a phahameng a anhedonia a motheo a theotsoe ho tloaelehileng ka mor'a 1 ho isa ho likhoeli tsa 2 bakeng sa bakuli ba sa kang ba khutla (). Thutong ea Garfield et al. (), bophahamo ba anhedonia bo fumanoe ho barupeluoa ba itšetlehileng ka opioid ha ba bapisoa le taolo e phetseng hantle (). Har'a barupeluoa ho opioid pharmacotherapy (ke hore, methadone le buprenorphine), ho ile ha fumanoa setsoalle sa bohlokoa pakeng tsa tšebeliso ea lithethefatsi tsa opioid tse seng molaong le lintlha tsa anhedonia, tse tšehetsang maikutlo a hore li-opioid li ka baka anhedonia. Ka lehlakoreng le leng, ha ho setsoalle se fumanoeng pakeng tsa nako ea bootsoa le anhedonia sehlopheng sa barupeluoa ba ts'ehetsang opioid.

Anhedonia le DUS le Depression Comorbidity

Lithuto tse peli ho tse 'ne tse mabapi le tšebeliso ea tahi ea joala (AUD) li tsepamisitse maikutlo ho comorbidity hape. Khatellong e kholo ea khatello ea maikutlo (MDD) -slampuli ea Mental Health ho General Population (MHGP), lithuto tsa 4,339 li fihletse litekanyetso tsa MDD (). Bathong ba MDD, ho ile ha bonoa lithuto tsa 413 AUD, ho kenyelletsa lithuto tsa 138 ka tšebeliso e mpe ea joala le 275 e nang le ts'ebeliso ea joala. Anhedonia e ne e amahanngoa le tšebeliso e mpe ea joala sehlopheng se nang le MDD le AUD ha se bapisoa le sehlopha se se nang AUD (OR 1.66).

Mohlala oa batho ba tsoang sesoleng sa 916 ba hlahetseng likotsi tsa sesole sa US o nkuoe bukeng e kholo ho tsoa ho National Health and Resilience in Veterans Study (NHRVS, ). Ho ile ha khethoa sephutheloana se ileng sa fana ka ketsahalo e bohloko ka ho fetisisa "e mpe" ho Traumatic History Screen. Mohlala ona o senang tlhaiso-leseling, ho ile ha fumanoa likamano lipakeng tsa mofuta o supileng o nyalisitsoeng oa matšoao a PTSD le tšebeliso ea lino tse tahang. Bosholu ba nako ea bophelo, hammoho le dysphoric arousal and has negative, li ne li amana haholo le litlamorao tsa joala tsa selemo se fetileng.

MDD comorbidity le eona e ithutoa le lipampiring tsa nicotine hape. Lenaneong la MDD / dysthymia la bakuli ba tsoang VA Healthcare System ho la Northeast United States, ba tsubang ba tepelletseng maikutlo ba 36 ba ne ba bapisoa le batho ba sa tsubang ba maikutlo ba 44 (). Ba tsubang ba sithabetsang maikutlo ba tlalehile anhedonia e ngata le ho fokotsa karabelo. Leha ho le joalo, mosebetsing o boima oa ho ithuta, batho ba tsubang ba tepelletseng maikutlo ba bontšitse lerato le matlafatsang le khothatsang khafetsa, le fanang ka maikutlo a hore batho ba tsubang ba tepelletseng maikutlo ba bonts'a thuto e thehiloeng moputsong e matla.

Leventhal et al. () e fetole kamano pakeng tsa anhedonia le maikutlo a sithabetsang le ho khutla hape ka nicotine bakeng sa pherekano ea bophelo bo sithabetsang e thehiloeng CIDI. Ho sithabela maikutlo ha hoa ka ha bolela esale pele phello ea ho tlohela, ha anhedonia e etsa joalo ().

Bakeng sa cannabis, thuto e le 'ngoe feela e neng e tsepamisitse maikutlo ho comorbidity pakeng tsa CUD le MDD. Feingold et al. () a khetha sehlotšoana sa MDD ho tsoa lipatlisisong tsa naha mme a fihlela qeto ea hore boemo ba tšebeliso ea cannabis bo ne bo amahanngoa le matšoao a eketsehileng ka tatellano, haholo anhedonia, ha litheko tsa tefo li ne li sa fapana lipakeng tsa MDD ka kapa ka ntle ho CUD ().

Rizvi et al. () e bonts'itse hore anhedonia e bohlokoa haholo ho bakuli ba MDD ba sebelisang li-benzodiazepines, ka anhedonia e le ponelopele e matla ea ts'ebeliso e tloaelehileng ea benzodiazepine ().

Phuputso e le 'ngoe ea fMRI e bontsitse moputso o fokolisitsoeng oa "ventral striatum reacaction" ho ea ka chelete) e amanang le kotsi e eketsehang bakeng sa anhedonia, haholo-holo bakeng sa barupeluoa ba ileng ba pepesetsoa khatello ea bophelo ba pele (). Sena se ka fana ka maikutlo a hore ho batho bana ka kotloloho, ts'usumetso ea ts'usumetso e senyehile.

Anhedonia le Phello ho Phekolo ea DUS

Boithuto bo bongata bo bontšitse phello e bohloko ea anhedonia ho phello ea kalafo. Tlalehong e kholo e sa sebetseng ea ho khaotsa ho tsuba e sa sebetseng hantle e sa sebetseng hantle, mefuta e mene e ikhethileng ea ho khaotsa ho ts'oaroa e ile ea tsebahala: sehlopha se leka-lekaneng sa ho tlohela se ne se le monyetla oa ho tlaleha matšoao a phahameng a lefu le leng la tlala. Sehlopha sa anhedonia se batlang litakatso tse phahameng se tlaleha maemo a phahameng a litakatso le anhedonia. Sehlopha se amehang sa ho khaola se ne se ipeha kotsing ea ho tsepamisa maikutlo le ho se sebetse hantle. Sehlopha sa tlala se tlaetse tlala ea letsatsi la ho khaotsa, empa e le tlase matšoao a mang. Sehlopha sa "anhedonia" se neng se lakatsa ho ea holimo se ile sa tlaleha ho lahloa ha 8 bekeng e tlase mme sa khutla hape empa se ne se na le monyetla o fokolang oa ho fumana tokisetso ea motsoako oa nicotine tekong ena ().

Phuputsong e 'ngoe ea kalafo ea ho khaotsa ho tsuba le barupeluoa ba 1,469, nako ea bophelo ba anhedonia e boletse esale pele menyetla e eketsehileng ea ho khutla hape ka mor'a libeke tsa 8 le likhoeli tsa 6 (). Ho feta moo, anhedonia ea kamora ho tlohela mosebetsi e ne e amahanngoa le ho fokotseha ha moriti oa ho khutlela morao hape le ho inehela ho tlase ha beke ea 8. Liphumano tse tšoanang li bontšitsoe thutong ea Piper ba sebelisa moralo le mokhoa o tšoanang (). Ba tlalehetse ho se ikoetlise ho tlase kamora libeke tsa 8 bakeng sa sehlopha se phahameng sa takatso ea anhedonia.

Wardle et al. () e bonts'itse hore anhedonia e amana le sephetho se seng sa kalafo (joalo ka, urineine e mpe ea koae) ho barupeluoa ba itšetlehileng ka koae ka mor'a taolo ea maemo a tšohanyetso. Hape, dopamine-agonist (L-DOPA) ha ea ka ea ntlafatsa sephetho lithutong tsena, ebile phello ea L-DOPA ha e fetoloa ke anhedonia ().

Ke feela thutong e le 'ngoe moo anhedonia e bileng le phello e ntle kalafong (). Litekong tsa ho tlohela tleliniking ka 21-mg nicotine patch ka letsatsi bakeng sa libeke tsa 8, barupeluoa ba 70 e ne e le anhedonic e thehiloeng ho SHAPS. Batho ba tsubang anhedonic ba ne ba ka 'na ba tlohela ho etsa joalo.

Puisano

Tlhahlobisong ena e senolang, re bonts'a lipampiri tsa lipatlisiso tsa mantlha tsa 32 tse hlahlobang anhedonia le kamano ea eona le mathata a tšebeliso ea lithethefatsi. Liphetho li fana ka lipontšo tsa hore 1) anhedonia e amana le mathata / lits'oaetso tsa ts'ebeliso ea lithethefatsi le ho teba ha tsona, 2) anhedonia e hlahella haholo ho DUS ka khatello ea maikutlo ea maikutlo le maikutlo a bophelo ba pejana, 3) anhedonia e ka ba tšobotsi le boemo ba mmuso ho maemo a eona kamanong le DUS, le 4) anhedonia e batla e ama hampe sephetho sa kalafo sa DUS. Kamora nako, bopaki bo bongata bo supa ho anhedonia e susumetsang e le karohano e kholo ea anhedonia kamanong ea eona le DUS.

Ka kakaretso, lintho tse fumanoeng tlhahlobisong ena, tse lebisang lingoloa lilemong tse fetileng tsa 5, li tsamaellana le tlhahlobo ea pejana ea Garfield et al. (). Ntle le lintho tse fapaneng tsa tlhekefetso, tse fumanoeng tlhahlobisong ena li fana ka matšoao a hore anhedonia - joalo ka mohopolo o pharaletseng - e amana le ho teba ha DUS le DUS. Leha ho le joalo, liphumano tsena li hloka ho shejoa ka bohlale. Ehlile, palo ea lithuto tse sebelisang sehlopha sa taolo e lula e fokola haholo. Hape, mehato e boima e sebelisitsoeng lithutong tsohle tse fapaneng e fapana haholo, e siea toloko e toloka e le thata. Ka kakaretso palo ea lithuto e lula e fokola haholo ha e bapisoa le palo ea lithuto tse phatlalalitsoeng mabapi le tšusumetso / taolo ea matla ho SUD. Sena sea hlolla. Ho joalo, ka pampiri ea tumellano ea morao-rao, RDoC Positive Valence System (Moputso oa Meputso, Tebello, Ts'ebetso ea Ts'ebetso, Ho Ithuta Meputso, Habit) e ile ea beoa pele joalo ka sebaka sa bohlokoa mabapi le pathogenesis ea likhathatso tse lemalloang, e kentsoeng bothateng ba ho qaleha, ho tswela pele, le bohlokoa ba lefu lena (). Anhedonia e ka beoa borokhong ba litsamaiso tse ntle le tse ntle tsa Valence, empa metsoalle e haufi le moputso oa moputso, tebello ea moputso, le thuto ea moputso. Taba ena ea theoretical le seo re se fumaneng tlhahlobo ea rona se bontša hore anhedonia e lokela ho tsotelloa ka ho fetesisa.

Ho feta moo, anhedonia e nkoa e le mohopolo oa bohlokoa oa "transdiagnostic" o ka tlasa mathata a mangata a fapaneng a kelello, mohlala, khatello ea maikutlo, ho ferekana ha kelello le lefu la kelello (schizophrenia).). Mathata ana kaofela a amana, ka mekhoa e fapaneng, ho fetotsoeng moputso oa moputso. Kamora nako, anhedonia e kanna ea ba le bohlokoa bakeng sa ho phunya le lingoliloeng tse ntseng li hola ka karolo ea ts'oaetso ea pathogeneis ea mafu a kelello a kang mathata a ho feto-fetoha ha maikutlo le khatello ea maikutlo (). Ho latela pono ena, ho ka nahanoa hore ho ba le ts'oaetso ea ts'oaetso ea ts'oaetso ea ramatiki ho ka baka khokahanyo lipakeng tsa ts'ebeliso e mpe ea lithethefatsi (khatello ea bophelo ba pele) le anhedonia.

Palo e kholo ea (e kholo) thutong ena e tsepamisitse maikutlo ho comorbidity mme e fane ka lipontšo tsa hore bakuli ba DUS ba nang le bothata ba ho feto-fetoha ha maikutlo ba comorbid ba ne ba le maemo a holimo a anhedonia ha ba bapisoa le lihlopha tse le 'ngoe tsa tlhahlobo ea mafu. Liphetho tsena li fana ka mabaka a hore maikutlo a hore anhedonia e ka ba sesosa se tloaelehileng sa lisosa tsa lefu lena kapa bonyane mofuta o mong le o mong oa lona. Subtypes ea khatello ea maikutlo le anhedonia ke eona e hlahelletseng e sa tsoa buelloa. Haholo-holo, ho na le morero oa "ho ruruha" o nang le ts'oaetso ea ts'oaetso ea ts'ebetso ea methapo e ka tsamaisang khokahanyo lipakeng tsa khatello ea maikutlo le matšoao a anhedonic (). Ho khahlisang, mathata a bongoaneng a bongoana e ka ba e 'ngoe ea lintlha tsa bohlokoa ka ho fetisisa tse lokisang ho ba kotsing ea methapo ea kutlo. Hoa makatsa hore liphuputso tse peli tekong ena li bontšitse khokahano e hlakileng lipakeng tsa anhedonia le ts'ebeliso e mpe ea lithethefatsi, haholoholo ho palo ea batho ba hlasetsoeng ke koluoa ​​(, ). Ka lebaka la ho ata ha mathata a bongoana bongoaneng kahara batho ba nang le DUS, lithuto tsa nako e tlang li hloka ho hlahloba hore na sehlotšoana sena se amana le anhedonia.

Patlisiso mabapi le anhedonia mathateng a mang a mafu a kelello, mohlala, khatello ea maikutlo le eona e ka thusa ho fana ka leseli le eketsehileng mabapi le hore na ho etsa lipatlisiso ka anhedonia ho SUD ho hloka ho etsoa joang. Joalokaha ho boletsoe kaholimo, litlaleho tsa boithati ke sesebelisoa se sebelisoang haholo, ha ba sa khone ho khetholla likarolo tse fapaneng tsa ts'ebetso ea moputso le ho ithuta ka moputso. Libukeng tsa khatello ea maikutlo, leha ho le joalo, likarolo tse fapaneng tsa moputso mabapi le anhedonia li ka aroloa ho latela lithuto tse ngata tse kopantseng mesebetsi ea boits'oaro le methapo ea kutlo, haholo lithuto tse amanang le liketsahalo (ERP). Lithuto tse nchafatsang li ka ba molemo hape, ho nka mohopolo oa hore paradigms tsa FMRI ha li khone ho latela likarolo tse lebelletsoeng, tsa ho kopanya le tsa ho ithuta tsa ho sebetsana le moputso (). Ho khothalletsoa mokhoa oa multimodal o sebelisa li-paradigms tse tšoanang mererong ea lipatlisiso tsa nako e tlang.

Lintlha tse tsoang tlhahlobong ena li bonts'a liphetho tse tsoakaneng mabapi le semelo sa boemo ba anhedonia bo maemong a ts'ebeliso ea lithethefatsi. Boithuto bo bong bo fana ka ts'ehetso ho khopolo ea hore anhedonia e ka ba tšekamelo e bakang kotsi ea ho qala ts'ebeliso ea lithethefatsi le ho nyoloha kapele. Sena se tsamaisana le mohopolo oa ho iphekola oo ho oona lintho li sebelisoang ho buella mathata a mongobo kapa bofokoli ba moputso oa kahare (). Bacha ba nang le khatello e matla ea maikutlo le ho ikoalla hape ba na le monyetla oa ho noa joala bo felletseng, ba na le monyetla oa ho lemalla pele, mme ba kotsing e kholo ea ho qaleha ha ts'ebeliso ea tšebeliso ea lino tse tahang.). Tumellanong le sena, anhedonia e ka tšelisoa e le mokhoa o ka ba kotsing oa ho sebelisa li-trajectories tsa pele le keketseho e latelang ea kotsi ea DUS. Hypothesis e boetse e tsamaisana le phokotso ea tlhaelo ea moputso (). Ka nako e tšoanang, lithuto tse fapaneng tlhahlobisong ena li bonts'a hore anhedonia e amana le ts'ebeliso e mpe ea lithethefatsi le ho ikhula ha e ntse e ntlafala ha nako e ntse e feta. Sena se tsamaisana le lithuto tsa pejana tse bonts'ang ntlafatso ea karabelo ea moputso nakong ea kalafo le ho itima lijo (). Liphumano tsena li bonts'a semelo sa mmuso. Leha ho le joalo, lithuto tsa nako e telele li lula li haella haholo, ke hore, tlhahlobisong ena, ke thuto e le 'ngoe feela e ileng ea latela tsela ea anhedonia nakong ea likhoeli tsa 6 ea ho tlohela mosebetsi e bonts'a ntlafatso ha nako e ntse e feta (). Kahoo, sephetho sefe kapa sefe mabapi le tšobotsi kapa mmuso ke sona se ikemiselitseng pele.

Lithuto tse 'maloa tekong ena li bonts'itse tšusumetso e mpe ea anhedonia tseleng ea DUS le phello ea kalafo, ke ho re, ho iketla nakoana ka mora nakoana le litekanyetso tse phahameng tsa ho khutla hape. Sena ke bopaki ba liphumano tse hlahisitsoeng tlhahlobisong ea pejana mabapi le sehlooho sena se bonts'ang hore anhedonia e eketsa monyetla oa ho khutla hape mme e amana le ho lakatsa (). Patlisisong ea khatello ea maikutlo, anhedonia e susumetsa lefu lena hampe. Sena se boetse se tlalehiloe kahare ho kalafo ea khatello ea maikutlo (-). Ho ka nahanoa hore anhedonia e le tšobotsi ea transdiagnostic modulates lefu le sephetho.

Tlas'a kalafo ea khatello ea maikutlo, kalafo e teng ea kelello le ea bongaka e bontšitse hore ha e na thuso bakeng sa ho phekola anhedonia. Tse ling tsa li-antidepressant tse sebelisoang khafetsa, mohlala, fluoxetine, li ka ba tsa mpefatsa matšoao a anhedonic (-). Ho bohlokoa, kalafo e ncha e kang ketamine e bonts'oa e na le ntlafatso ea anhedonia, esita le khatello ea maikutlo e thibelang kalafo (, ). Sena ke se khahlisang, hape ho tloha ponong ea ho supa hore ketamine e ka sebelisoa maemong a kalafo a DUS (). Le ha ho le joalo, hajoale, ha ho na lipatlisiso tse hatisitsoeng tse lekang katleho ea ketamine e le kalafo ho bakuli ba nang le DUS le khatello ea maikutlo / anhedonia comorbidity, ena ke mohopolo o khahlisang. Se khahlisang tlhahlobisong ena ke ho fumana hore phekolo ea ho nkela sebaka (ho joalo ka, nicotine patch) e ka ba molemo ka ho khetheha bakeng sa ba tsubang ba inang holimo ho anhedonia. Powers et al. () e bonts'itse monyetla o eketsehang oa ho itima lijo haufinyane o sebelisa 21-mg / day nicotine patch therapy. Cook et al. () e hlokometse hore kalafo e sebelisang pheko ea nicotine e sebelisang anhedonia le ho fokotsa matšoao a ho khaotsa ho tsuba nakong ea nakoana ea ho ila thipa. Ho feta moo, batho ba sa tsubang ba sa tsubeng ba bontša ho fokotseha ho hoholo ha matšoao a sithabetsang nakong ea kalafo ea nicotine patch, ho fana ka maikutlo a hore NRT (le patch ea nicotine) e kanna ea ba le litlamorao tse joalo ka (). Ho 'nile ha nahanoa hore ho pepesetsoa ha nicotine ho oketsa hypoactivation meahong ea bohlokoa ea tseleng ea moputso (ho kenyelletsa le caudate, nucleus accumbens, putamen) har'a batho ba tsubang ba nang le khatello ea maikutlo, ka data e bonts'ang ts'ebetso e ngata ka mor'a taolo ea nicotine ka har'a dorsal striatum nakong ea moputso o lebelloang preortal cortex e amanang le maikutlo a ho putsa (). Ho tlameha ho hopoloa hore mehlala ea barupeluoa ba anhedonic thutong ea Powers et al. () e ne e le nyane, mme ho haella ha boemo ba placebo ho ile ha etsa hore ho be thata ho fumana litlatsetso ka phello ea kalafo ea nicotine patch ho anreatonia kapa khatello ea maikutlo hangata. Kamora nako, ho na le bopaki ba pele ba hore aripiprazole e ka khothaletsa ho itlopa joala le ho fokotsa ho hasana, mohlomong dessyecik dopaminergic le serotonergic moduction ho li-circkey tsa subonto-subcortical (). Leha ho le joalo, sena se hloka phetisetso ea nako e tlang.

Ha li kopantsoe hammoho, le ha ho le thata ho phekola lefu lena ebile le ka ama tšoaetso ea mafu, lithuto tsena tsa pele li na le ts'episo ea ho holisa kalafo ea nakong e tlang — ea meriana le ea bongaka.

Liphumano tse hlahlobisisong ena li hloka ho shejoa ka botebo. Ho hlokahala hore ho nkuoe meeli e 'maloa. Taba ea pele, lithuto tse ngata li bua haholo ka ho tsuba. Lintho tse ling tsa tlhekefetso li lula li sa hlomphuoe haholo, 'me mabapi le bokhoba ba boitšoaro, tlhaiso-leseling eo ke zero. Kamora nako ea bohlokoa le ho feta, lithutong tsohle, ho sebelisitsoe mehato e fapaneng ea anhedonia. Ha ho na e 'ngoe ea mehato ena e tsejoang hore na ba lekanya boholo ba anhedonia hakae, hape ha ho na tlhahisoleseling e lekaneng ea hore na mehato ena e amana joang. Sena se etsa hore papiso lipakeng e se khonehe mme e ka ikarabella bakeng sa liphetho tse hananang. Taba ea boraro, ho sebelisitsoe meralo e fapaneng ea lipalo le mehlala, e leng se etsang hore ho be thata ho fihlela liqeto tse akaretsang mabapi le kamano ea nakoana le kamano lipakeng tsa anhedonia le DUS. Kamora nako, ea rona ke tlhahlobo e hlalosang, e phetoang, e totobatsang karolo e pharalletseng ea likamano tsa anhedonia le DUS. Lithuto tse susumetsoang ke kelello tsa nako e tlang lia hlokahala litlamorao tsa bongaka le ho hlakiseng lisosa tsa methati le methapo ea kutlo.

Nahanisisa

Liphumano tse tsoang tlhahlobisong ena li fana ka matšoao a hore anhedonia e ka ba ea bohlokoa bakeng sa kutloisiso e ntle ea pathogenesis ea likhathatso le litlatsetso tsa bona. Anhedonia e ka ipaka e le boemo ba bohlokoa ba transdiagnostic bo bakang likhathatso tse ngata kamanong ea bona le litšenyehelo tse fapaneng tsa ho lokisa meputso. Ka har'a National Institute of Mental Health's (NIH) Research Domain Criteria (RDoC), anhedonia e nkuoa e le lintlha tsa RDoC Element (boitsoaro) kahare ho li-Domain and Constru leka: 1) Domain: Negative Valence Systems; 2) Ho aha: Ho lahleheloa le ho aha. Leha ho le joalo, anhedonia e kanna ea hokahanngoa le libaka tse ling, ke hore, Positive Valence Systems (), ka hona anhedonia e kanna ea bohlokoa ho koala litsamaiso tsena le / kapa ho bonts'a li-subgroups / methane e fapaneng.

Leha ho le joalo, ho fapana le lefapha la ho qobelloa, ho ithuta ha anhedonia kamanong le DUS ke ntho ea tlhaho feela. Ho bonahatsa sena ha se palo e nyane feela ea lithuto empa hape le phapang ea litekanyetso le likhopolo tse sebelisitsoeng lithutong tse fapaneng. Ho na le tlhoko e kholo ea tumellano ea ho hlalosa boholo ba methapo ea kutlo le lisebelisoa tsa ho lekanya hantle / lisebelisoa tsa ho thusa tšimo hore e tsoele pele ka potlako. Tlas'a moelelo ona, pampiri ea tumellano ea machaba ea tumellano e khethollang likarolo tsa bohlokoa ka ho fetisisa tsa tlhalohanyo ea methapo ea kutlo ke bohato ba bohlokoa (). A re boneng hore na anhedonia e fumana sebaka joang mohlaleng ona.

Menehelo ea Mongoli

Bangoli bohle ba kentse letsoho ho qapteng le ho ngola ho ngotsoeng ka letsoho.

Tlhōlisano ea Tlhaloso

Bangoli ba bolela hore lipatlisiso li ne li etsoa ka ho se be le likamano leha e le life tsa khoebo kapa tsa lichelete tse ka nkoang e le khohlano e ka 'nang ea e-ba le thahasello.

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