title: Social-economical decision making in current and remitted major depression.
abstract: BACKGROUND
  Prosocial emotions related to self-blame are important in guiding human altruistic decisions. These emotions are elevated in major depressive disorder (MDD), such that MDD has been associated with guilt-driven pathological hyper-altruism. However, the impact of such emotional impairments in MDD on different types of social decision-making is unknown.
  
  
  METHODS
  In order to address this issue, we investigated different kinds of altruistic behaviour (interpersonal cooperation and fund allocation, altruistic punishment and charitable donation) in 33 healthy subjects, 35 patients in full remission (unmedicated) and 24 currently depressed patients (11 on medication) using behavioural-economical paradigms.
  
  
  RESULTS
  We show a significant main effect of clinical status on altruistic decisions (p = 0.04) and a significant interaction between clinical status and type of altruistic decisions (p = 0.03). More specifically, symptomatic patients defected significantly more in the Prisoner's Dilemma game (p < 0.05) and made significantly lower charitable donations, whether or not these incurred a personal cost (p < 0.05 and p < 0.01, respectively). Currently depressed patients also reported significantly higher guilt elicited by receiving unfair financial offers in the Ultimatum Game (p < 0.05).
  
  
  CONCLUSIONS
  Currently depressed individuals were less altruistic in both a charitable donation and an interpersonal cooperation task. Taken together, our results challenge the guilt-driven pathological hyper-altruism hypothesis in depression. There were also differences in both current and remitted patients in the relationship between altruistic behaviour and pathological self-blaming, suggesting an important role for these emotions in moral and social decision-making abnormalities in depression.
authors.affiliation: Neuroscience & Psychiatry Unit,The University of Manchester & Manchester Academic Health Sciences Centre, School of Medicine,Manchester,UK.
authors.forename: E
authors.initials: E
authors.lastname: Pulcu
authors.affiliation: Neuroscience & Psychiatry Unit,The University of Manchester & Manchester Academic Health Sciences Centre, School of Medicine,Manchester,UK.
authors.forename: E J
authors.initials: EJ
authors.lastname: Thomas
authors.affiliation: Neuroscience & Psychiatry Unit,The University of Manchester & Manchester Academic Health Sciences Centre, School of Medicine,Manchester,UK.
authors.forename: P D
authors.initials: PD
authors.lastname: Trotter
authors.affiliation: Neuroscience & Psychiatry Unit,The University of Manchester & Manchester Academic Health Sciences Centre, School of Medicine,Manchester,UK.
authors.forename: M
authors.initials: M
authors.lastname: McFarquhar
authors.affiliation: Neuroscience & Psychiatry Unit,The University of Manchester & Manchester Academic Health Sciences Centre, School of Medicine,Manchester,UK.
authors.forename: G
authors.initials: G
authors.lastname: Juhasz
authors.affiliation: Department of Psychiatry and MRC Wellcome Trust Behavioural and Clinical Neuroscience Institute,The University of Cambridge,Cambridge,UK.
authors.forename: B J
authors.initials: BJ
authors.lastname: Sahakian
authors.affiliation: Neuroscience & Psychiatry Unit,The University of Manchester & Manchester Academic Health Sciences Centre, School of Medicine,Manchester,UK.
authors.forename: J F W
authors.initials: JF
authors.lastname: Deakin
authors.affiliation: Neuroscience & Psychiatry Unit,The University of Manchester & Manchester Academic Health Sciences Centre, School of Medicine,Manchester,UK.
authors.forename: I M
authors.initials: IM
authors.lastname: Anderson
authors.affiliation: Neuroscience & Psychiatry Unit,The University of Manchester & Manchester Academic Health Sciences Centre, School of Medicine,Manchester,UK.
authors.forename: R
authors.initials: R
authors.lastname: Zahn
authors.affiliation: Neuroscience & Psychiatry Unit,The University of Manchester & Manchester Academic Health Sciences Centre, School of Medicine,Manchester,UK.
authors.forename: R
authors.initials: R
authors.lastname: Elliott
mesh_terms: D000328:Adult; D000533:Altruism; D003299:Cooperative Behavior; D003657:Decision Making / Q000502:physiology*; D003865:Major Depressive Disorder / Q000503:physiopathology*; D005260:Female; D006167:Guilt; D006801:Humans; D008297:Male; D008875:Middle Aged; D009014:Morals
keywords: Ultimatum Game