EPIDEMIOLOGY AND BURDEN OF DISEASE OF MAJOR DEPRESSIVE DISORDER (MDD) WITH ANHEDONIA IN ASIA PACIFIC
Authors: Herr *Keira Joann , Berk Michael , Huang Wei-Lieh , Kato Tadafumi , Lee Jung Goo , Ng Chong Guan , Wang Zhen , Webb Thomas , Kasahara-Kiritani Mami , Vandervoort Lawrence , Grillo Vince 
Published: February 2025

Background

Major depressive disorder (MDD) is a pervasive mental health condition with a substantial global disease burden. Anhedonia is a core symptom of MDD and has been associated with poorer disease prognosis and suboptimal treatment response [1–3], however, the prevalence of anhedonia and its impact on health related quality of life outcomes is not well-understood. There is a paucity of data on the burden of MDD with anhedonia in Asia Pacific (APAC) [4–6], this is potentially due to anhedonia not typically being managed distinctly from MDD [4,5]. This study aims to provide an overview of the prevalence and quality of life of MDD with anhedonia in Asia Pacific (APAC), with focus on Australia, Mainland China, Japan, Malaysia, South Korea, and Taiwan.

Methods

This cross-sectional web-based survey was conducted in April - May 2023 with 38,623 adults (aged 18 or over years without self-reported bipolar disorder or schizophrenia) among the general populations in Australia, Mainland China, Japan, Malaysia, South Korea, and Taiwan. Respondents, having self-reported MDD diagnosis, and Patient Health Questionnaire-9 (PHQ-9[7]) score 10 or over were classified as MDD respondents and were sub-categorized based on Snaith-Hamilton Pleasure Scale (SHAPS [8]) into anhedonia (cut-off score&gt;2) (MDD-ANH) and non-anhedonia (MDD non-ANH) groups.

Bivariate analysis was used to analyze data pertaining to sociodemographic and health-related QoL (HRQoL). To ensure representativeness, the outcomes were age- and gender-weighted using United Nations population estimates of each country/territory [9].

Results

The anhedonia prevalence among MDD in APAC was estimated 52.5%, ranging between 45.1% in Malaysia and 66.9% in Japan among MDD patients. The MDD point prevalence ranged from 3.4% in Japan to 21.9% in Australia (region: 16.1%). Across APAC, MDD-ANH reported worse HRQoL than MDD non-ANH through RAND mental health composite (RAND MHC [10]) (23.79 vs 30.59, p&lt;.0001) and EuroQol-5- dimension index (EQ-5D [11]) (0.67 vs 0.72, p&lt;.0001). MDD-ANH respondents in all countries/territories reported worse RAND MHC (except South Korea) and EQ-5D (except Australia and South Korea) than MDD non-ANH (p&lt;0.05).

Discussion and Conclusion

This is the first large-scale study to quantify ANH prevalence amongst MDD patients in APAC, with 52.5% of patients reporting anhedonia. The point MDD prevalence in APAC was estimated 16.1%, ranging between 3.4% in Japan to 21.9% in Australia, indicating an increase on previous studies [12–18]. MDD participants with anhedonia reported a consistently lower HRQoL. This suggests anhedonia is associated with a greater disease burden and is an area of unmet need warranting targeted evidence based therapeutic considerations.

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