| Background Obsessive-compulsive disorder (OCD) is a common mental illness and is listed as one of the top 10 disabling conditions for loss of income and reduced quality of life. Psychological pain is an important cause of anhedonia in patients with OCD, which is also related to psychosomatic symptoms. It is of great significance to explore the pathway of anhedonia between psychological pain and psychosomatic symptoms to improve the diagnosis and treatment strategy of patients with OCD. Objective This study explores the role of anhedonia in the relationship between psychological distress and somatic symptoms in patients with OCD, with the aim of providing a reference for reducing somatic symptoms in patients with obsessive-compulsive disorder. Methods According to the inclusion and exclusion criteria, 90 OCD patients who met the diagnostic criteria of the International Classification of Diseases and were treated in the outpatient department of Mental Health Center of Ningxia Medical University General Hospital from September 2023 to November 2024 were selected as the study objects. General information questionnaire, anhedonia Rating Scale (DARS), Kessler Psychological Pain Scale (K10) and Psychosomatic Symptom Scale (PSSS) were used to evaluate the general information, anhedonia level, psychological pain level and psychosomatic symptom severity of the patients, respectively. pearson correlation analysis was used to examine the correlation between the scores of each scale in obsessive-compulsive patients. Model 4 in Process 4.0 of SPSS 26.0 plug-in was used to test the action path of anhedonia between psychological pain and psychosomatic symptoms, and Bootstrap was used to test the mediation effect. Results A total of 84 patients (93.33%) completed the valid questionnaire. K10 score was positively correlated with PSSS total score (r=0.559, P<0.01), psychological symptom score (r=0.460, P<0.01) and physical symptom score (r=0.551, P<0.01). K10 score was negatively correlated with DARS total score (r=-0.527, P<0.01). The total score of DARS was negatively correlated with that of PSSS (r=-0.497, P<0.01). Anhedonia was the pathway of action between psychological pain and psychosomatic symptoms, and the indirect effect size was 0.148 (95% CI: 0.042-0.278), accounting for 26.48% of the total effect. Conclusion The psychosomatic symptoms of OCD patients can be directly affected by psychological pain, or indirectly affected by anhedonia. |