Comparative multidimensional psychosocial profiles of major depressive disorder patients with higher versus lower anhedonia burden: a cross-sectional study

BACKGROUND: Anhedonia is a core symptom of major depressive disorder (MDD) and is linked to greater severity, poorer functioning, and elevated suicide risk, yet its broader psychosocial correlates in routine clinical settings remain insufficiently characterized. This study compared multidimensional psychosocial profiles between MDD patients with higher versus lower anhedonia burden. METHODS: In this cross-sectional study, outpatients aged 18-45 years with MDD were recruited between January and December 2024; 125 participants with complete and valid questionnaires were included in the final analyses. Anhedonia was assessed using the Snaith-Hamilton Pleasure Scale (SHAPS). The SHAPS total score quantified anhedonia severity, and a dichotomized SHAPS score > 5 was used as an operational threshold for a higher anhedonia group. Depressive and anxiety symptoms, childhood trauma, family functioning, social support, personality traits, and dysfunctional attitudes were also evaluated. RESULTS: Overall, 52.0% of patients were classified into the higher anhedonia group. In the lower PHQ-9-M stratum, the higher anhedonia group showed lower extraversion than the lower anhedonia group (p = 0.001; q = 0.009; Hedges' g = - 0.863, 95% CI - 1.424 to - 0.296), whereas no other prespecified higher-order measures survived FDR correction. Among patients in the higher PHQ-9-M stratum, none of the measures survived FDR correction; nominal differences were observed for dysfunctional attitudes and psychoticism. CONCLUSIONS: A higher SHAPS-based anhedonia burden was common among young adult outpatients with MDD. In PHQ-9-M stratified comparisons, psychosocial distinctions between patients with higher versus lower anhedonia burden were overall modest, with lower extraversion in the lower PHQ-9-M stratum representing the primary signal. Larger multicenter longitudinal studies using multi-method assessments are warranted to validate and better characterize anhedonia-related psychosocial profiles.