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Proposed diagnostic criteria for apathy in Alzheimer’s disease and other neuropsychiatric disorders

Published online by Cambridge University Press:  16 April 2020

P. Robert ,
C.U. Onyike ,
A.F.G. Leentjens ,
K. Dujardin ,
P. Aalten ,
S. Starkstein ,
F.R.J. Verhey ,
J. Yessavage ,
J.P. Clement  and
D. Drapier
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P. Robert*
Affiliation:
Centre Mémoire de Ressources et de Recherche, CHU de Nice, Nice, France
C.U. Onyike
Affiliation:
Division of Geriatric Psychiatry and Neuropsychiatry, The Johns Hopkins School of Medicine, Baltimore, MD, USA
A.F.G. Leentjens
Affiliation:
Department of Psychiatry, Maastricht University Medical Center, Alzheimer Center Limburg, Maastricht, The Netherlands
K. Dujardin
Affiliation:
Neurology and Movement Disorders Unit, EA2683, Faculty of Medicine and Lille University Hospital, Lille, France
P. Aalten
Affiliation:
Department of Psychiatry, Maastricht University Medical Center, Alzheimer Center Limburg, Maastricht, The Netherlands
S. Starkstein
Affiliation:
Department of Psychiatry, University of Western Australia, Australia
F.R.J. Verhey
Affiliation:
Department of Psychiatry, Maastricht University Medical Center, Alzheimer Center Limburg, Maastricht, The Netherlands
J. Yessavage
Affiliation:
Sierra-Pacific Mental Illness Research, Education, and Clinical Center, Palo Alto VA Health Care System, USA Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, USA
J.P. Clement
Affiliation:
J.P. Clement CMRR du Limousin, CHU-CH, Limoges, France
D. Drapier
Affiliation:
Department of Psychiatry, Unité de Recherche Universitaire «Comportements et noyaux gris centraux» Université de Rennes, France
F. Bayle
Affiliation:
Université Paris Descartes, CH Sainte-Anne, INSERM U 796, Paris, France
M. Benoit
Affiliation:
Centre Mémoire de Ressources et de Recherche, Department of Psychiatry CHU de Nice, France
P. Boyer
Affiliation:
Institute of Mental Health Research, Ottawa, Ontario, Canada
P.M. Lorca
Affiliation:
Université d’Auvergne, CHU Clermont-Ferrand, France
F. Thibaut
Affiliation:
University Hospital Ch Nicolle, INSERM U 614, University of Medicine, Rouen, France
S. Gauthier
Affiliation:
McGill Center for Studies in Aging, Douglas Mental Health Research Institute, Canada
G. Grossberg
Affiliation:
Department of Neurology and Psychiatry, St Louis University School of Medicine, St Louis, MO, USA
B. Vellas
Affiliation:
Gerontopole, Inserm U 558, CHU Toulouse, France
J. Byrne
Affiliation:
Old Age Psychiatry, University of Manchester, UK
*
*Corresponding author. Centre Mémoire de Ressources et de Recherche, Pavillon Mossa, Hôpital de Cimiez, 4 Avenue Reine Victoria, 06003 NICE Cedex 1, France. Tel.: +33 4 92 03 47 70; fax: +33 4 92 03 47 72. E-mail address: [email protected] (P. Robert).
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Abstract

There is wide acknowledgement that apathy is an important behavioural syndrome in Alzheimer’s disease and in various neuropsychiatric disorders. In light of recent research and the renewed interest in the correlates and impacts of apathy, and in its treatments, it is important to develop criteria for apathy that will be widely accepted, have clear operational steps, and that will be easily applied in practice and research settings. Meeting these needs is the focus of the task force work reported here.

The task force includes members of the Association Française de Psychiatrie Biologique, the European Psychiatric Association, the European Alzheimer’s Disease Consortium and experts from Europe, Australia and North America. An advanced draft was discussed at the consensus meeting (during the EPA conference in April 7th 2008) and a final agreement reached concerning operational definitions and hierarchy of the criteria.

Apathy is defined as a disorder of motivation that persists over time and should meet the following requirements. Firstly, the core feature of apathy, diminished motivation, must be present for at least four weeks; secondly two of the three dimensions of apathy (reduced goal-directed behaviour, goal-directed cognitive activity, and emotions) must also be present; thirdly there should be identifiable functional impairments attributable to the apathy. Finally, exclusion criteria are specified to exclude symptoms and states that mimic apathy.

Keywords

ApathyAlzheimer’s diseaseNeuropsychiatryDiagnostic criteria
Type
Original article
Information
European Psychiatry , Volume 24 , Issue 2 , March 2009 , pp. 98 - 104
Copyright
Copyright © Elsevier Masson SAS 2009

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