Comparative efficacy of interventions for transdiagnostic anhedonia: a network meta-analysis.
Yong-Ming Wang, Fei Chen, Yun-Wu Hou et al.
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In 30 seconds
This network meta-analysis compared interventions for anhedonia across transdiagnostic populations, including people with major depressive disorder or schizophrenia and healthy individuals with trait anhedonia. It included 60 reports covering 61 trials and 5,794 participants; the primary network comprised 35 trials and 17 treatment nodes. Compared with pooled controls, estimates favoured vortioxetine 10 mg/day (standardized mean difference [SMD] −0.90), left DLPFC-targeted TMS (SMD −0.55), behavioural activation (SMD −0.52), and meditation (SMD −0.49). Heterogeneity was substantial (I² = 71.90%).
Key findings
- Versus pooled controls, vortioxetine 10 mg/day had an SMD of −0.90 for anhedonia outcomes.
- Left DLPFC-targeted TMS, behavioural activation, and meditation had SMDs of −0.55, −0.52, and −0.49, respectively, versus pooled controls.
- Left DLPFC-targeted TMS had the most consistent evidence pattern across the overall and major depressive disorder networks, supported by five direct trials in the overall network.
- Heterogeneity was substantial (I² = 71.90%), while the design-by-treatment test did not indicate global inconsistency.
Why it matters
Anhedonia occurs across diagnostic groups, and this analysis compares pharmacological, neuromodulatory, and psychological approaches using a shared outcome framework. The results identify interventions with favourable estimates and highlight the relative consistency of evidence for left DLPFC-targeted TMS. Substantial heterogeneity and the need for diagnosis-specific trials mean that comparative estimates should be interpreted cautiously.
What to keep in mind
Substantial heterogeneity (I² = 71.90%) limits confidence in the pooled comparisons. The primary network included 35 trials and 17 treatment nodes, and certainty of evidence was assessed but is not reported in the abstract.