Impact of Major Depressive Disorder with Prominent Anhedonia on Polypharmacy, Use of Healthcare Services, and Health-related Quality of Life in the United States

Abstract: Background: Despite the prevalence of major depressive disorder (MDD), little is known about the burden of anhedonia, a core MDD symptom associated with MDD severity, functional impairment, and poor prognosis. Methods: Adults (≥18 years) with MDD from the nationally representative Medical Expenditure Panel Survey (2016–2019) were classified into prominent (MDD-ANH) or no/low (other-MDD) anhedonia based on the first item of the Patient Health Questionnaire-2. We assessed polypharmacy (≥two psychotropic medications), healthcare services, and health-related quality of life (HRQoL) measured by SF-12 Physical and Mental Component Summary (PCS, MCS) scores. Results: We identified 1075 individuals with MDD-ANH and 4037 with other-MDD. Although polypharmacy was slightly higher in the MDD-ANH (89.4%) than the other-MDD group (85.7%), those with MDD-ANH were about twice as likely to have used mood stabilizers (13% vs 7.1%), antipsychotics (6.2% vs 2.9%), anxiolytics (6.5% vs 3.2%), and ADHD medications (7.1% vs 4.3%) with their MDD treatments. Individuals with MDD-ANH had 47% and 46% more emergency department (33.1 vs 22.6 per 100 individuals) and office (1305.2 vs 896.9 per 100 individuals) visits and 44% more hospitalizations (14.3 vs 9.9 per 100 individuals) than those with other-MDD. HRQoL was significantly lower in the MDD-ANH than the other-MDD group (PCS: 46.2 vs 50.3, MCS: 30.9 vs 47.1). Conclusion: Prominent anhedonia is associated with higher polypharmacy and healthcare services use, and lower HRQoL among individuals with MDD. These findings highlight the need for novel treatments to improve outcomes, ultimately reducing clinical and humanistic burden among individuals with MDD with prominent anhedonia.Short Description: Our study aimed to assess the clinical and humanistic burden associated with major depressive disorder (MDD) with prominent anhedonia in US adults. Adults with MDD were identified from the Medical Expenditure Panel Survey (2016–2019) and classified as having prominent anhedonia (MDD-ANH) and no/low anhedonia (other-MDD). Individuals with MDD-ANH had higher polypharmacy use and MDD related treatments, higher healthcare resource utilization, and lower health-related quality of life compared to adults from other-MDD group.Name of Sponsoring Organization(s): Janssen Scientific Affairs, LLC