Meta-analysis finds distinct hedonic deficits in schizophrenia and depression

Anhedonia, a transdiagnostic symptom for schizophrenia and depression, exists in subclinical individuals at risk of the two disorders. Prior meta-analytic reviews seldom considered both anticipated pleasure and anticipated displeasure. We conducted a three-level meta-analysis on anticipated pleasure and displeasure in people with schizophrenia and depression, and their subclinical counterparts. Clinical and subclinical individuals of the schizophrenia spectrum reported less anticipated pleasure than controls (k = 37, 1464 participants, g = -0.22, p = 0.032), but reported similar anticipated displeasure as controls (k = 20, 769 participants, g = 0.09, p = 0.345). Clinical and subclinical individuals of depression anticipated less pleasure (k = 21, 1162 participants, g = -0.62, p = 0.003) and more displeasure (k = 15, 954 participants, g = 0.82, p = 0.033) than controls. Comparisons of the schizophrenia and depression samples yielded no significant difference for effect sizes of either anticipated pleasure or anticipated displeasure. For schizophrenia spectrum, heterogeneity of anticipated pleasure was explained by sociality of anticipated stimuli. For participants with depression, higher severity of depressive symptoms were associated with larger between-group effects on anticipated pleasure and displeasure. After accounting for publication bias, the between-group effects remained of a similar magnitude. We elucidated the patterns of impaired anticipated emotions in clinical and subclinical samples of the schizophrenia and depression. Social anticipated pleasure may be a potential screening target for schizophrenia, while impaired anticipated emotions may serve as a marker for depression.