The Pleasure Deficit in Schizophrenia

Thought, emotional and motivational disorders have long been recognized as clinical features of schizophrenia. This paper will focus on one deficit frequently observed in schizophrenia, hypohedonia, the diminished capacity to experience pleasure. As hypohedonia is difficult to distinguish from lack of social interest, avoidance and withdrawal from activity and interpersonal contacts, the following aspects of hypohedonia will be reviewed: definition; etiology; demographic characteristics; specificity to schizophrenia; related clinical features; and prognosis. Of special concern will be the implications of hypohedonia for the practice of occupational therapy and the possibilities for O.T. clinical intervention. Finally, the frustration and difficulties experienced by the clinician in developing the therapeutic relationship and maintaining professional interest will be addressed.