Reward processing dysfunction in major depression, bipolar disorder and schizophrenia

• Type of Material: Article
• Authors: Alexis E. Whitton, McLean Hospital; Michael T. Treadway, Emory University; Diego A. Pizzagalli, McLean Hospital
• Language: English
• Date: 2015-01-11
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2014 Wolters Kluwer Health
• Final Published Version (URL): http://dx.doi.org/10.1097/YCO.0000000000000122
• Title of Journal or Parent Work: Current Opinion in Psychiatry
• ISSN: 0951-7367
• Volume: 28
• Issue: 1
• Start Page: 7
• End Page: 12
• Grant/Funding Information: Dr. Treadway was partially supported by NIMH K99 MH102355 grant.; Preparation of this review was partially supported by the National Institute of Mental Health under Award Number R01MH101521.; Dr. Whitton was partially supported by an Andrew P. Merrill Memorial Research Fellow Award from McLean Hospital.
• Keywords: Bipolar Disorder; Reward; Humans; Signal Transduction; Schizophrenia; Neural Pathways; Depressive Disorder, Major; Schizophrenic Psychology
• Research Categories: Health Sciences, Mental Health

Abstract

Purpose of review: This article reviews the recent literature on reward processing dysfunction in major depression (MDD), bipolar disorder and schizophrenia, with a focus on approach motivation, reward learning and rewardbased decision-making. Recent findings: Emerging evidence indicates the presence of reward processing abnormalities across all three disorders, supporting a transdiagnostic approach. In particular, findings are consistent with a role of abnormal phasic striatal dopamine signaling, which is critical for reinforcement learning, efficient mobilization of effort to obtain reward and allocation of attention to reward-predictive cues. Specifically, reward-related striatal signaling appears blunted in MDD and the negative symptoms of schizophrenia, elevated in bipolar (hypo)mania, and contextually misallocated in the positive symptoms of psychosis. However, whether shared or distinct pathophysiological mechanisms contribute to abnormal striatal signaling across the three disorders remains unknown. Summary: New evidence of reward processing abnormalities in MDD, bipolar disorder and schizophrenia has led to a greater understanding of the neural processes associated with symptomatology common across these conditions (e.g., anhedonia). Dissecting various subcomponents of reward processing that map onto partially different neurobiological pathways and investigating their dysregulation in different psychiatric disorders holds promise for developing more targeted, and hopefully efficacious treatment and intervention strategies. .