{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:53:29Z","timestamp":1791298409239,"version":"4.1.0"},"reference-count":41,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Emotional blunting is frequently reported during antidepressant treatment but remains conceptually underdefined. Reduced emotional reactivity and affective intensity may represent therapeutic benefit, an adverse effect, residual depressive symptomatology, or a context\u2010dependent combination of these possibilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims and Objectives<\/jats:title>\n                    <jats:p>To clarify the phenomenology and clinical significance of antidepressant\u2010associated emotional blunting, distinguish it from residual depression, anhedonia, and apathy, and consider its implications for long\u2010term prescribing, shared decision\u2010making, and patient\u2010centred care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Evidence from phenomenological and qualitative accounts, survey\u2010based and clinical studies, neurobiological research, patient\u2010reported outcome literature, and relevant ethical and clinical guidance was narratively integrated to examine the prevalence, mechanisms, subjective meanings, and management of emotional blunting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Emotional blunting is reported by a substantial proportion of antidepressant\u2010treated patients, although estimates vary because of differences in definitions, instruments, populations, and study designs. Evidence suggests that serotonergic antidepressants may dampen the processing of both rewarding and aversive stimuli, but medication effects cannot always be clearly separated from residual illness. Patients' appraisals are heterogeneous: emotional attenuation may be experienced as protective or acceptable during acute treatment yet burdensome, alienating, or inconsistent with personal recovery during maintenance treatment. Misclassification may lead to inappropriate dose escalation, unnecessary continuation, or premature discontinuation. Clinical responses should therefore be individualised and may include maintaining treatment, dose reduction, switching, psychological or psychosocial interventions, or planned discontinuation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Emotional blunting is best understood as a therapeutically ambivalent, patient\u2010reported outcome whose significance varies with illness phase, treatment goals, perceived benefits, and individual values. Systematic enquiry and shared decision\u2010making can support more clinically appropriate and person\u2010centred antidepressant care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jep.70604","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:32:40Z","timestamp":1791297160000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Emotional Blunting During Antidepressant Treatment: Implications for Clinical Decision\u2010Making and Patient\u2010Centred Care"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5742-905X","authenticated-orcid":false,"given":"Carlos","family":"De las Cuevas","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Dermatology and Psychiatry University of La Laguna Tenerife Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"OECD Indicators","author":"OECD","year":"2023"},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","DOI":"10.1787\/ae3016b9-en","volume-title":"Health at a Glance 2021","author":"OECD","year":"2021"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp19X701405"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2018.08.027"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(19)30032-X"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/da.21993"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.108.051110"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2012.01.030"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2017.05.048"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.2174\/1574886313666180605095130"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1159\/000491524"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.19com12794"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/hup.2871"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1017\/neu.2023.6"},{"key":"e_1_2_10_16_1","volume-title":"DSM\u20105","author":"American Psychiatric Association","year":"2013"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1176\/jnp.3.3.243"},{"key":"e_1_2_10_18_1","volume-title":"Medical Dictionary for Regulatory Activities (MedDRA\u00ae): Introductory Guide. Version 26.0","author":"World Health Organization","year":"2023"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2014.01.042"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12991-022-00387-1"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/ijnp\/pyad066"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2009.11.001"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.161.7.1256"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291712000591"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1017\/S146114571300062X"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1159\/000083999"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0030240"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1017\/S2045796017000555"},{"key":"e_1_2_10_29_1","doi-asserted-by":"crossref","DOI":"10.1093\/med:psych\/9780195094862.001.0001","volume-title":"Speaking of Sadness: Depression, Disconnection, and the Meanings of Illness. Oxford","author":"Karp D. A.","year":"1996"},{"key":"e_1_2_10_30_1","volume-title":"The Illness Narratives: Suffering, Healing, and the Human Condition","author":"Kleinman A.","year":"1988"},{"key":"e_1_2_10_31_1","doi-asserted-by":"crossref","DOI":"10.1017\/CBO9780511581649","volume-title":"Personal Recovery and Mental Illness: A Guide for Mental Health Professionals","author":"Slade M.","year":"2009"},{"key":"e_1_2_10_32_1","volume-title":"Principles of Biomedical Ethics","author":"Beauchamp T. L.","year":"2013"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12991-023-00447-0"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.5653"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1461145702002870"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-012-2077-6"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1176\/ps.2006.57.11.1636"},{"key":"e_1_2_10_38_1","volume-title":"NICE Guideline NG222","author":"NICE","year":"2022"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2007.09.004"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.3109\/09638237.2012.734653"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.2147\/NDT.S485109"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-015-0678-4"}],"container-title":["Journal of Evaluation in Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jep.70604","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jep.70604","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jep.70604","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:32:43Z","timestamp":1791297163000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jep.70604"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":41,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/jep.70604"],"URL":"https:\/\/doi.org\/10.1111\/jep.70604","archive":["Portico"],"relation":{},"ISSN":["1356-1294","1365-2753"],"issn-type":[{"value":"1356-1294","type":"print"},{"value":"1365-2753","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-03-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70604"}}