1 - (SYM23) Examining Anhedonia in the Daily Lives of Those with Depression, Bipolar Disorder and Schizophrenia

Anhedonia, defined as the diminished capacity to experience pleasure, has long been considered a core clinical feature of schizophrenia and mood disorders. However, traditional clinician-rated scales rely on retrospective recall of emotional experiences and do not capture the dynamic fluctuations of emotional experiences in daily life. This study aimed to characterize the profile of anhedonia transdiagnostically and highlight how anhedonia manifests differently when measured via retrospective clinician-rated interviews and real-time ecological momentary assessment (EMA) ratings. Participants with schizophrenia (N=41), bipolar disorder (N=47), depression (N=48), and healthy controls (N=51) completed measures of cognition and clinician-rated scales of anhedonia, along with a 14-day EMA protocol reporting on their anticipatory and consummatory pleasure, motivation, and activities. Preliminary findings indicate that clinician ratings showed significant overlap in anhedonia severity across patient groups. In contrast, EMA ratings show heightened levels of anhedonia in the depression group, while the bipolar and schizophrenia group did not. Further, analyses revealed a significant interaction between cognition and clinician-rated anticipatory anhedonia (p < .02) in predicting daily anhedonia. This interaction suggests that lower cognitive functioning moderates the relationship between clinician and EMA ratings, resulting in a greater discrepancy between clinician-rated and EMA-reported anhedonia. These findings suggest that cognitive deficits may act as a barrier to accurate clinical assessment, which require internal monitoring and retrospective reporting required during clinical interviews. These results also suggest that EMA provides a more nuanced phenotype of anhedonia than clinician ratings alone. Integrating more frequent, real-time data collection into clinical assessments may improve diagnostic precision and better inform personalized treatment strategies.