Anhedonia and Amotivation in Psychiatric Outpatients with Fully Remitted Stimulant Use Disorder
Corresponding Author
Adam M. Leventhal PhD
Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island
Center for Alcohol and Addiction Studies, Brown University, Box G-S121-4, Providence, RI, 02912. E-mail: [email protected]Search for more papers by this authorChristopher W. Kahler PhD
Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island
Search for more papers by this authorLara A. Ray PhD
Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island
Search for more papers by this authorKristen Stone PhD
Department of Psychiatry and Human Behavior, Brown Alpert Medical School, Providence, Rhode Island
Search for more papers by this authorDiane Young PhD
Department of Psychiatry and Human Behavior, Brown Alpert Medical School, Providence, Rhode Island
Search for more papers by this authorIwona Chelminski PhD
Department of Psychiatry and Human Behavior, Brown Alpert Medical School, Providence, Rhode Island
Search for more papers by this authorMark Zimmerman MD
Department of Psychiatry and Human Behavior, Brown Alpert Medical School, Providence, Rhode Island
Search for more papers by this authorCorresponding Author
Adam M. Leventhal PhD
Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island
Center for Alcohol and Addiction Studies, Brown University, Box G-S121-4, Providence, RI, 02912. E-mail: [email protected]Search for more papers by this authorChristopher W. Kahler PhD
Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island
Search for more papers by this authorLara A. Ray PhD
Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island
Search for more papers by this authorKristen Stone PhD
Department of Psychiatry and Human Behavior, Brown Alpert Medical School, Providence, Rhode Island
Search for more papers by this authorDiane Young PhD
Department of Psychiatry and Human Behavior, Brown Alpert Medical School, Providence, Rhode Island
Search for more papers by this authorIwona Chelminski PhD
Department of Psychiatry and Human Behavior, Brown Alpert Medical School, Providence, Rhode Island
Search for more papers by this authorMark Zimmerman MD
Department of Psychiatry and Human Behavior, Brown Alpert Medical School, Providence, Rhode Island
Search for more papers by this authorAbstract
This study evaluated whether psychiatric outpatients with a past stimulant use disorder in full remission for ≥ 2 months (STIM+, n = 204) and those with no history of stimulant use disorder (STIM−, n = 2070) differed in the prevalence of current anhedonia and amotivation. Results showed that a significantly greater proportion of STIM+ participants reported anhedonia and amotivation than STIM− participants. The relation between stimulant use disorder history and anhedonia remained robust after controlling for other relevant clinical and demographic factors. These findings suggest that anhedonia may be a preexisting risk factor or protracted effect of stimulant misuse.
REFERENCES
- 1 Satel SL, Price LH, Palumbo JM, McDougle CJ. Clinical phenomenology and neurobiology of cocaine abstinence: a prospective inpatient study. Am J Psychiatry.. 1991; 148: 1712–1716.
- 2 Coffey SF, Dansky BS, Carrigan MH, Brady KT. Acute and protracted cocaine abstinence in an outpatient population: a prospective study of mood, sleep and withdrawal symptoms. Drug Alcohol Depend.. 2000; 59: 277–286.
- 3 Gawin FH, Kleber HD. Abstinence symptomatology and psychiatric diagnosis in cocaine abusers: clinical observations. Arch Gen Psychiatry.. 1986; 43: 107–113.
- 4 McGregor CM, Srisurapanont M, Jittiwutikarn J, Laobhripatr S, Wongtan T, White JM. The nature, time course and severity of methamphetamine withdrawal. Addiction.. 2005; 100: 1300–1329.
- 5 Weddington WW, Brown BS, Haertzen CA, Cone EJ. Changes in mood, craving, and sleep during short-term abstinence reported by male cocaine addicts: a controlled, residential study. Arch Gen Psychiatry.. 1990; 47: 861–868.
- 6 Kalechstein AD, Newton TF, Leavengood AH. Apathy syndrome in cocaine dependence. Psychiatry Res.. 2002; 109: 97–100.
- 7 Tremblay LK, Naranjo CA, Cardenas L, Herrmann N, Busto UE. Probing brain reward system function in major depressive disorder: altered response to dextroamphetamine. Arch Gen Psychiatry.. 2002; 59: 409–416.
- 8 Tremblay LK, Naranjo CA, Graham SJ et al. Functional neuroanatomical substrates of altered reward processing in major depressive disorder revealed by a dopaminergic probe. Arch Gen Psychiatry.. 2005; 62: 1228–1236.
- 9 Falck RS, Wang J, Siegal HA, Carlson RG. The prevalence of psychiatric disorder among a community sample of crack cocaine users: an exploratory study with practical implications. J Nerv Ment Dis.. 2004; 192: 503–507.
- 10 Baker A, Dawe S. Amphetamine use and co-occurring psychological problems: review of the literature and implications for treatment. Australian Psychologist.. 2005; 40: 88–95.
- 11 Uslaner J, Kalechstein A, Richter T, Ling W, Newton T. Association of depressive symptoms during abstinence with the subjective high produced by cocaine. Am J Psychiatry.. 1999; 156: 1444–1446.
- 12 Newton TF, Kalechstein AD, De La Garza R II, Cutting DJ, Ling W. Apathy predicts hedonic but not craving response to cocaine. Pharmacol Biochem Behav.. 2005; 82: 236–240.
- 13 Zimmerman M. Integrating the assessment methods of researchers in routine clinical practice: The Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project. Standardized Evaluation in Clinical Practice. 22nd ed.. MF First. 2003 29–74.
- 14 Riehman KS, Iguchi MY, Anglin MD. Depressive symptoms among amphetamine and cocaine users before and after substance abuse treatment. Psychol Addict Behav.. 2002; 16: 333–337.
- 15 Miles H, Johnson S, Amponsah-Afuwape S, Leese M, Finch E, Thornicroft G. Characteristics of subgroups of individuals with psychotic illness and a comorbid substance use disorder. Psychiatr Serv.. 2003; 54: 554–561.
- 16 First MB, Spitzer RL, Williams JBW, Gibbon M. Structed Clinical Interview for DSM-IV (SCID) American Psychiatric Association Washington DC. 1997.
- 17 Guy W. ECDEU assessment manual for psychopharmacology National Institute of Mental Health Rockville Md.. 1976 76–338 U.S. Dept. of Health, Education, and Welfare publication ADM.
- 18 McGlinchey JB, Zimmerman M, Young D, Chelminski I. Diagnosing major depressive disorder, VIII: are some symptoms better than others?. J Nerv Ment Dis. 2006; 194: 785–790.
- 19 Zimmerman M, Mattia JI. Psychiatric diagnosis in clinical practice: is comorbidity being missed?. Compr Psychiatry. 1999; 40: 182–191.
- 20 The SAS System for Windows. Version 8.2 SAS Institute Inc. Cary NC. 2003.
- 21 Janiri L, Martinotti G, Dario T et al. Anhedonia and substance-related symptoms in detoxified substance-dependent subjects: a correlation study. Neuropsychobiology.. 2005; 52: 37–44.
- 22 Bovasso GB. Cannabis abuse as a risk factor for depressive symptoms. Am J Psychiatry. 2001; 158: 2033–2037.
- 23 Leventhal AM, Chasson GS, Tapia E, Miller EK, Pettit JP. Measuring hedonic capacity in depression: a psychometric analysis of three anhedonia scales. J Clin Psychol.. 2006; 62: 1545–1558.
- 24 Bressan RA, Crippa JA. The role of dopamine in reward and pleasure behaviour—review of data from preclinical research. Acta Psychiatr Scand. 2005; 111 Suppl. 427 14–21.
