Oğuz Bilal KARAKUŞ, İkranur SEZER, Kübra KALAYCI, Hayriye Rumeysa ERDEM, Ayşe Tuğçe UYSAL, Merve MENEMENCİOĞLU, Onur Burak DURSUN
Van Medical Journal - 2026;33(3):357-365
Introduction: Anhedonia is increasingly recognized as a transdiagnostic construct associated with multiple dimensions of psychopathology. However, its relationship with somatic symptom burden in adolescents, independent of core internalizing symptoms such as depression and anxiety, remains unclear. This study aimed to examine the association between anhedonia and somatic symptoms in adolescents and to determine whether this relationship persists beyond depressive and anxiety symptom severity. Materials and Methods: A total of 242 adolescents aged 12-18 years referred to a child and adolescent psychiatry outpatient clinic were included. Psychiatric diagnoses were established using a semi-structured clinical interview. Depression severity was assessed with a clinician-rated instrument, while anhedonia, anxiety symptoms, and somatic symptoms were evaluated using validated self-report measures. Hierarchical regression analyses were conducted in three steps: Model I included age and sex; Model II added depression and anxiety; and Model III included anhedonia. Results: Clinically significant anhedonia was identified in 27.7% of participants. Adolescents with anhedonia exhibited higher somatic symptom severity (p<0.001). Somatic symptom scores were positively correlated with depression and anxiety severity and negatively correlated with hedonic capacity (p<0.001). In hierarchical regression analyses, female sex (beta=0.295), depression (beta=0.410), and anxiety (beta=0.370) were significant predictors of somatic symptoms. In the final model, anhedonia remained an independent predictor (beta=-0.184, p=0.003), explaining additional variance beyond core internalizing symptoms. Conclusion: Anhedonia is independently associated with somatic symptom burden in adolescents. These findings suggest that somatic symptoms should be conceptualized not only as manifestations of internalizing psychopathology but also in relation to dysfunctions in reward-motivation systems and interoceptive processing.
