Can Understanding Changes in Pleasure and Motivation Help Us Personalize Depression Care?

June 18, 2026

Anhedonia, or the loss of ability to experience pleasure, is one of the core symptoms of major depressive disorder (MDD) and is often associated with poorer treatment outcomes. However, anhedonia is not a single experience; it can involve difficulties with anticipating future rewards, experiencing pleasure in the moment, and feeling motivated to pursue rewarding activities. A recent CAN-BIND study examined whether specific aspects of anhedonia could predict response to pharmacotherapy in individuals with major depressive disorder.

What is Anhedonia?

Anhedonia refers to a reduced ability to experience pleasure or interest in activities that were previously rewarding. It is a central symptom of depression and is associated with reduced quality of life, impaired functioning, and difficulties achieving full recovery.

Researchers increasingly recognize that anhedonia is a complex symptom with multiple components. These may include:

Anticipatory anhedonia, which refers to reduced ability to look forward to or expect pleasure from future experiences.
Consummatory anhedonia, which refers to reduced enjoyment during an experience itself.
Motivational deficits, which involve reduced drive or effort to pursue rewarding activities.

These different aspects may involve distinct psychological and biological processes. Understanding whether specific forms of anhedonia influence treatment response may help improve prediction of outcomes and support more personalized approaches to depression treatment.

How the Study Worked

This study analyzed data from participants with major depressive disorder enrolled in CAN-BIND. Participants received pharmacotherapy as part of their treatment, and researchers examined whether baseline characteristics of anhedonia were associated with subsequent treatment response. The researchers assessed different dimensions of anhedonia and evaluated whether particular patterns were linked to greater or poorer improvement following antidepressant treatment. By separating anhedonia into specific components rather than treating it as a single symptom, the study aimed to identify whether certain aspects of reward-related dysfunction could help predict who is more likely to respond to medication.

“Anhedonia is a heterogeneous symptom of depression that may reflect disruptions in multiple reward-related processes, including motivation, anticipation, and pleasure experience. Understanding these components may provide insight into variability in treatment response.”

What Did This Study Reveal?

The study demonstrated that different aspects of anhedonia may have different relationships with antidepressant treatment outcomes.

Specific dimensions of anhedonia were associated with differences in treatment response, suggesting that not all forms of reduced pleasure affect recovery in the same way.
Features related to reward anticipation and motivation may provide important information about treatment outcomes, as these processes influence whether individuals engage with and benefit from rewarding experiences.
Measuring anhedonia as a multidimensional symptom may provide greater clinical insight than assessing it as a single overall depression symptom.

The findings support the importance of considering specific symptom profiles when predicting antidepressant response and developing personalized treatment approaches.

Why This Matters

Although antidepressant treatments are effective for many individuals with depression, treatment response varies considerably between patients. Identifying characteristics that predict who is more likely to improve remains an important goal in psychiatry. Anhedonia is particularly important because it often persists even when other depressive symptoms improve. Persistent difficulties with pleasure, motivation, and reward processing can contribute to incomplete recovery and ongoing functional challenges. By identifying which aspects of anhedonia are associated with treatment outcomes, this research may help clinicians better understand individual differences in depression and guide future treatment strategies. This approach supports the development of more personalized models of care that consider the specific symptoms and biological processes affecting each person.

“A better understanding of symptom dimensions such as anhedonia may improve prediction of treatment outcomes and help identify patients who may benefit from additional or alternative therapeutic approaches…“

Limitations to Consider

The study focused on individuals receiving pharmacotherapy, meaning the findings may not directly apply to people receiving psychotherapy, neuromodulation treatments, or other interventions. Additionally, measures of anhedonia rely partly on self-report assessments, which may be influenced by individual experiences and perceptions. Because the study examined associations between anhedonia characteristics and treatment outcomes, it cannot determine whether specific forms of anhedonia directly cause differences in response. Future studies are needed to investigate whether treatments targeting reward processing can improve outcomes for individuals with prominent anhedonia.

Final Takeaway

This CAN-BIND study highlights that anhedonia is not a single symptom but a collection of related difficulties involving pleasure, motivation, and reward processing. Understanding these different components may improve our ability to predict antidepressant response and identify individuals who may require more targeted treatment approaches.

Citation: Uher, R., Rizvi, S. J., Quilty, L. C., Pavlova, B., Nunes, A., Foster, J. A., Lam, R. W., Milev, R., Müller, D. J., Taylor, V., Soares, C. N., Rotzinger, S., Kennedy, S. H., & Frey, B. N. (2025). Which aspects of anhedonia predict response to pharmacotherapy in major depressive disorder? Psychological Medicine, 56, e2. https://doi.org/10.1017/S0033291725102894.