Influence of Anhedonia and Self-Esteem on Daily-Life Decision-Making in Patients with Schizophrenia

ABSTRACT

OBJECTIVES: Decision-making in patients with schizophrenia has been known to be inefficient in both cognitive and affective aspects. The purpose of this study was to investigate the influence of anhedonia and self-esteem on the decision-making process in schizophrenia. METHODS: Twenty patients with schizophrenia and 21 healthy controls performed the ‘apparel purchase decision-making task’, during which they were asked to respond to the preference, fitness, and price suitability, before making the final purchase decision. Generalized estimating equation and correlation analysis were conducted to explore for the difference of decision making patterns and influential factors between the two groups. RESULTS: The patients showed lower odds ratio (OR) of the fitness on the apparel purchase decision than the controls [OR 0.190 ; 95% confidence interval (CI) 0.047–0.762, p = 0.019). In the patient group, there was no correlation between the number of purchased trials and the severity of anhedonia, but the number of purchased trials was negatively correlated with the Rosenberg Self-Esteem Scale score at a trend level (R = -0.436, p = 0.055). CONCLUSIONS: Patients with schizophrenia considered the fitness of clothes less than healthy controls on apparel purchasing decisions. Schizophrenia patients with lower self-esteem were intended to buy more clothes.