Anhedonia and suicidal ideation in young people with early psychosis: findings from a 2-year Italian follow-up study

TL;DR

This study finds that anhedonia, or the inability to feel pleasure, is linked to suicidal thoughts in young people with early psychosis, independent of depression.

Contribution

The study is one of the first to show a lasting link between anhedonia and suicidal ideation in early psychosis, independent of depression in FEP individuals.

Findings

Anhedonia scores were similarly high in both FEP and UHR groups.

Anhedonia was significantly associated with suicidal ideation in FEP over two years, independent of depression.

In UHR individuals, the link between anhedonia and suicidal thoughts was partially influenced by depression severity.

Abstract

Hedonic deficits have been extensively studied in schizophrenia, but little is known about their association with suicidal ideation in early psychosis. Along the clinical staging of psychosis, also Ultra-High Risk (UHR) individuals are characterized by hedonic deficits, which are currently considered as putative predictors of both psychosis conversion and poor social/role functioning.

The aim of this research was to examine the relationship between anhedonia and suicidal thoughts across a 2-year follow-up period in people with First Episode Psychosis (FEP) and at Ultra High Risk (UHR) of psychosis.

Ninty-six UHR and 146 FEP, aged 13–35 years, completed the Comprehensive Assessment of At-Risk Mental States (CAARMS) and the Beck Depression Inventory-II (BDI-II). The BDI-II “Anhedonia” subscale score to assess anhedonia and the CAARMS “Depression” item 7.2 subscore to measure depression were used across the 2 years of follow-up. Hierarchical regression analyses were performed.

No difference in anhedonia scores between FEP and UHR individuals was found. In the FEP group, a significant enduring association between anhedonia and suicidal ideation was found at baseline and across the follow-up, independent of clinical depression. In the UHR subgroup, the enduring relationship between anhedonia and suicidal thoughts were not completely independent from depression severity.

Anhedonia is relevant in predicting suicidal ideation in early psychosis. Specific pharmacological and/or psychosocial interventions on anhedonia within specialized EIP program could reduce suicide risk overtime.

None Declared