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Dimensional psychiatry: Reward dysfunction and depressive mood across psychiatric disorders

MPG-Autoren
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Schlagenhauf,  Florian
Department of Psychiatry and Psychotherapy, Charité University Medicine Berlin, Germany;
Max Planck Fellow Group Cognitive and Affective Control of Behavioural Adaptation, MPI for Human Cognitive and Brain Sciences, Max Planck Society;

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Zitation

Hägele, C., Schlagenhauf, F., Rapp, M., Sterzer, P., Beck, A., Bermpohl, F., et al. (2015). Dimensional psychiatry: Reward dysfunction and depressive mood across psychiatric disorders. Psychopharmacology, 232(2), 331-341. doi:10.1007/s00213-014-3662-7.


Zitierlink: https://hdl.handle.net/11858/00-001M-0000-0029-AE0E-7
Zusammenfassung
Rationale: A dimensional approach in psychiatry aims to identify core mechanisms of mental disorders across nosological boundaries. Objectives: We compared anticipation of reward between major psychiatric disorders, and investigated whether reward anticipation is impaired in several mental disorders and whether there is a common psychopathological correlate (negative mood) of such an impairment. Methods: We used functional magnetic resonance imaging (fMRI) and a monetary incentive delay (MID) task to study the functional correlates of reward anticipation across major psychiatric disorders in 184 subjects, with the diagnoses of alcohol dependence (n = 26), schizophrenia (n = 44), major depressive disorder (MDD, n = 24), bipolar disorder (acute manic episode, n = 13), attention deficit/hyperactivity disorder (ADHD, n = 23), and healthy controls (n = 54). Subjects’ individual Beck Depression Inventory-and State-Trait Anxiety Inventory-scores were correlated with clusters showing significant activation during reward anticipation. Results: During reward anticipation, we observed significant group differences in ventral striatal (VS) activation: patients with schizophrenia, alcohol dependence, and major depression showed significantly less ventral striatal activation compared to healthy controls. Depressive symptoms correlated with dysfunction in reward anticipation regardless of diagnostic entity. There was no significant correlation between anxiety symptoms and VS functional activation. Conclusion: Our findings demonstrate a neurobiological dysfunction related to reward prediction that transcended disorder categories and was related to measures of depressed mood. The findings underline the potential of a dimensional approach in psychiatry and strengthen the hypothesis that neurobiological research in psychiatric disorders can be targeted at core mechanisms that are likely to be implicated in a range of clinical entities.