title: Dimensional psychiatry: reward dysfunction and depressive mood across psychiatric disorders.
abstract: BACKGROUND
  A dimensional approach in psychiatry aims to identify core mechanisms of mental disorders across nosological boundaries.
  
  
  OBJECTIVE
  We compared anticipation of reward between major psychiatric disorders, and investigated whether reward anticipation is impaired in several mental disorders and whether there is a common psychopathological correlate (negative mood) of such an impairment.
  
  
  METHODS
  We used functional magnetic resonance imaging (fMRI) and a monetary incentive delay (MID) task to study the functional correlates of reward anticipation across major psychiatric disorders in 184 subjects, with the diagnoses of alcohol dependence (n = 26), schizophrenia (n = 44), major depressive disorder (MDD, n = 24), bipolar disorder (acute manic episode, n = 13), attention deficit/hyperactivity disorder (ADHD, n = 23), and healthy controls (n = 54). Subjects' individual Beck Depression Inventory-and State-Trait Anxiety Inventory-scores were correlated with clusters showing significant activation during reward anticipation.
  
  
  RESULTS
  During reward anticipation, we observed significant group differences in ventral striatal (VS) activation: patients with schizophrenia, alcohol dependence, and major depression showed significantly less ventral striatal activation compared to healthy controls. Depressive symptoms correlated with dysfunction in reward anticipation regardless of diagnostic entity. There was no significant correlation between anxiety symptoms and VS functional activation.
  
  
  CONCLUSIONS
  Our findings demonstrate a neurobiological dysfunction related to reward prediction that transcended disorder categories and was related to measures of depressed mood. The findings underline the potential of a dimensional approach in psychiatry and strengthen the hypothesis that neurobiological research in psychiatric disorders can be targeted at core mechanisms that are likely to be implicated in a range of clinical entities.
authors: Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany, claudia.haegele@charite.de.
authors: Claudia
authors: C
authors: Hägele
authors: Florian
authors: F
authors: Schlagenhauf
authors: Michael
authors: M
authors: Rapp
authors: Philipp
authors: P
authors: Sterzer
authors: Anne
authors: A
authors: Beck
authors: Felix
authors: F
authors: Bermpohl
authors: Meline
authors: M
authors: Stoy
authors: Andreas
authors: A
authors: Ströhle
authors: Hans-Ulrich
authors: HU
authors: Wittchen
authors: Raymond J
authors: RJ
authors: Dolan
authors: Andreas
authors: A
authors: Heinz
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003863:Depression / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D001523:Mental Disorders / Q000503:physiopathology / Q000523:psychology*; D009042:Motivation; D011569:Psychiatric Status Rating Scales; D011570:Psychiatry / Q000379:methods; D012201:Reward