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Social-economical decision making in current and remitted major depression

Published online by Cambridge University Press:  10 October 2014

E. Pulcu ,
E. J. Thomas ,
P. D. Trotter ,
M. McFarquhar ,
G. Juhasz ,
B. J. Sahakian ,
J. F. W. Deakin ,
I. M. Anderson ,
R. Zahn  and
R. Elliott
E. Pulcu
Affiliation:
Neuroscience & Psychiatry Unit, The University of Manchester & Manchester Academic Health Sciences Centre, School of Medicine, Manchester, UK
E. J. Thomas
Affiliation:
Neuroscience & Psychiatry Unit, The University of Manchester & Manchester Academic Health Sciences Centre, School of Medicine, Manchester, UK
P. D. Trotter
Affiliation:
Neuroscience & Psychiatry Unit, The University of Manchester & Manchester Academic Health Sciences Centre, School of Medicine, Manchester, UK
M. McFarquhar
Affiliation:
Neuroscience & Psychiatry Unit, The University of Manchester & Manchester Academic Health Sciences Centre, School of Medicine, Manchester, UK
G. Juhasz
Affiliation:
Neuroscience & Psychiatry Unit, The University of Manchester & Manchester Academic Health Sciences Centre, School of Medicine, Manchester, UK Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary
B. J. Sahakian
Affiliation:
Department of Psychiatry and MRC Wellcome Trust Behavioural and Clinical Neuroscience Institute, The University of Cambridge, Cambridge, UK
J. F. W. Deakin
Affiliation:
Neuroscience & Psychiatry Unit, The University of Manchester & Manchester Academic Health Sciences Centre, School of Medicine, Manchester, UK
I. M. Anderson
Affiliation:
Neuroscience & Psychiatry Unit, The University of Manchester & Manchester Academic Health Sciences Centre, School of Medicine, Manchester, UK
R. Zahn
Affiliation:
Neuroscience & Psychiatry Unit, The University of Manchester & Manchester Academic Health Sciences Centre, School of Medicine, Manchester, UK Neuroscience and Aphasia Research Unit, The University of Manchester & Manchester Academic Health Sciences Centre, School of Psychological Sciences, Manchester, UK
R. Elliott*
Affiliation:
Neuroscience & Psychiatry Unit, The University of Manchester & Manchester Academic Health Sciences Centre, School of Medicine, Manchester, UK
*
*Address for correspondence: Dr R. Elliott, Neuroscience and Psychiatry Unit, The University of Manchester, Medical School, Stopford Building, Oxford Road, Manchester M13 9PL, UK. (Email: [email protected])
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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.

Method.

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.

Keywords

Charitable donationguiltmajor depressive disorderPrisoner's DilemmaUltimatum Game
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 6 , April 2015 , pp. 1301 - 1313
Copyright
Copyright © Cambridge University Press 2014 

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