The Trajectory of Anhedonic and Depressive Symptoms in Anorexia Nervosa: A Longitudinal and Cross-Sectional Approach.

Anhedonia, the inability to experience pleasure, is associated with depression, schizophrenia and also anorexia nervosa (AN). However, it remains unanswered whether anhedonic symptoms in AN are undernutrition-dependent depressive symptoms or a core feature of AN. Therefore, we aim at investigating the trajectory of anhedonic and depressive symptoms over the course of the disorder. Self-reported symptoms were collected in 35 nonmedicated acutely ill, 33 long-term recovered patients and 62 healthy females. The majority of the acutely ill (n = 24) were followed up after >15% weight restoration (short-term recovery). Anhedonia was found to be increased during the acute, short-term as well as long-term recovered state while depressive symptoms showed a reduction over time. Additionally, depressive symptoms were negatively associated with body mass index in acute patients. This provides evidence of anhedonia being a trait-characteristic of AN, relatively unrelated to undernutrition-dependent depressive symptoms. Results are discussed with regard to implications for treatment and prevention.