Anhedonia and schizophrenia: how much is in the eye of the beholder?

The subjective experience of anhedonia may differ from its outward expression. We examined the relationship between anhedonia and objective features of schizophrenia. Thirty-six chronic schizophrenic patients were administered the Snaith-Hamilton Pleasure Scale (SHAPS) and clinical and cognitive assessments were performed. SHAPS scores were higher (more anhedonia) than reported for normal subjects and recovered depressives but lower than for depressed patients. A total of 41.7% of the subjects scored within the normal range. SHAPS scores showed moderate correlation with negative symptoms but not test or illness variables. Mean levels of negative symptoms did not differ significantly between hedonic and anhedonic groups. We conclude that most subjects suffering from chronic schizophrenia experience anhedonia but many show normal hedonic tone. Many schizophrenic patients may have a greater capacity to experience pleasure than is apparent to the people around them.