title: Temporal discounting in major depressive disorder.
abstract: BACKGROUND
  Major depressive disorder (MDD) is associated with abnormalities in financial reward processing. Previous research suggests that patients with MDD show reduced sensitivity to frequency of financial rewards. However, there is a lack of conclusive evidence from studies investigating the evaluation of financial rewards over time, an important aspect of reward processing that influences the way people plan long-term investments. Beck's cognitive model posits that patients with MDD hold a negative view of the future that may influence the amount of resources patients are willing to invest into their future selves.
  
  
  METHODS
  We administered a delay discounting task to 82 participants: 29 healthy controls, 29 unmedicated participants with fully remitted MDD (rMDD) and 24 participants with current MDD (11 on medication).
  
  
  RESULTS
  Patients with current MDD, relative to remitted patients and healthy subjects, discounted large-sized future rewards at a significantly higher rate and were insensitive to changes in reward size from medium to large. There was a main effect of clinical group on discounting rates for large-sized rewards, and discounting rates for large-sized rewards correlated with severity of depressive symptoms, particularly hopelessness.
  
  
  CONCLUSIONS
  Higher discounting of delayed rewards in MDD seems to be state dependent and may be a reflection of depressive symptoms, specifically hopelessness. Discounting distant rewards at a higher rate means that patients are more likely to choose immediate financial options. Such impairments related to long-term investment planning may be important for understanding value-based decision making in MDD, and contribute to ongoing functional impairment.
authors.affiliation: School of Medicine, Neuroscience and Psychiatry Unit,University of Manchester and Manchester Academic Health Science Centre,Manchester,UK.
authors.forename: E
authors.initials: E
authors.lastname: Pulcu
authors.affiliation: School of Medicine, Neuroscience and Psychiatry Unit,University of Manchester and Manchester Academic Health Science Centre,Manchester,UK.
authors.forename: P D
authors.initials: PD
authors.lastname: Trotter
authors.affiliation: School of Medicine, Neuroscience and Psychiatry Unit,University of Manchester and Manchester Academic Health Science Centre,Manchester,UK.
authors.forename: E J
authors.initials: EJ
authors.lastname: Thomas
authors.affiliation: School of Medicine, Neuroscience and Psychiatry Unit,University of Manchester and Manchester Academic Health Science Centre,Manchester,UK.
authors.forename: M
authors.initials: M
authors.lastname: McFarquhar
authors.affiliation: School of Medicine, Neuroscience and Psychiatry Unit,University of Manchester and Manchester Academic Health Science Centre,Manchester,UK.
authors.forename: G
authors.initials: G
authors.lastname: Juhasz
authors.affiliation: Department of Psychiatry,University of Cambridge, and MRC Wellcome Trust Behavioural and Clinical Neuroscience Institute,Cambridge,UK.
authors.forename: B J
authors.initials: BJ
authors.lastname: Sahakian
authors.affiliation: School of Medicine, Neuroscience and Psychiatry Unit,University of Manchester and Manchester Academic Health Science Centre,Manchester,UK.
authors.forename: J F W
authors.initials: JF
authors.lastname: Deakin
authors.affiliation: School of Medicine, Neuroscience and Psychiatry Unit,University of Manchester and Manchester Academic Health Science Centre,Manchester,UK.
authors.forename: R
authors.initials: R
authors.lastname: Zahn
authors.affiliation: School of Medicine, Neuroscience and Psychiatry Unit,University of Manchester and Manchester Academic Health Science Centre,Manchester,UK.
authors.forename: I M
authors.initials: IM
authors.lastname: Anderson
authors.affiliation: School of Medicine, Neuroscience and Psychiatry Unit,University of Manchester and Manchester Academic Health Science Centre,Manchester,UK.
authors.forename: R
authors.initials: R
authors.lastname: Elliott
mesh_terms: D000328:Adult; D065786:Delay Discounting / Q000502:physiology*; D003865:Major Depressive Disorder / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012201:Reward