Is it time to revise the diagnostic criteria for apathy in brain disorders? The 2018 international consensus group

P. Robert; K. L. Lanctot; L. Aguera-Ortiz; P. Aalten; F. Bremond; M. Defrancesco; C. Hanon; R. David; B. Dubois; K. Dujardin; M. Husain; A. Konig; R. Levy; V. Mantua; D. Meulien; D. Miller; H. J. Moebius; J. Rasmussen; G. Robert; M. Ruthirakuhan; F. Stella; J. Yesavage; R. Zeghari; V. Manera

doi:10.1016/j.eurpsy.2018.07.008

Is it time to revise the diagnostic criteria for apathy in brain disorders? The 2018 international consensus group

P. Robert^*, K. L. Lanctot, L. Aguera-Ortiz, P. Aalten, F. Bremond, M. Defrancesco, C. Hanon, R. David, B. Dubois, K. Dujardin, M. Husain, A. Konig, R. Levy, V. Mantua, D. Meulien, D. Miller, H. J. Moebius, J. Rasmussen, G. Robert, M. RuthirakuhanF. Stella, J. Yesavage, R. Zeghari, V. Manera

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background: Apathy is a very common behavioural and psychological symptom across brain disorders. In the last decade, there have been considerable advances in research on apathy and motivation. It is thus important to revise the apathy diagnostic criteria published in 2009. The main objectives were to: a) revise the definition of apathy; b) update the list of apathy dimensions; c) operationalise the diagnostic criteria; and d) suggest appropriate assessment tools including new technologies.

Methods: The expert panel (N = 23) included researchers and health care professionals working on brain disorders and apathy, a representative of a regulatory body, and a representative of the pharmaceutical industry. The revised diagnostic criteria for apathy were developed in a two-step process. First, following the standard Delphi methodology, the experts were asked to answer questions via web-survey in two rounds. Second, all the collected information was discussed on the occasion of the 26th European Congress of Psychiatry held in Nice (France).

Results: Apathy was defined as a quantitative reduction of goal-directed activity in comparison to the patient's previous level of functioning (criterion A). Symptoms must persist for at least four weeks, and affect at least two of the three apathy dimensions (behaviour/cognition; emotion; social interaction; criterion B). Apathy should cause identifiable functional impairments (criterion C), and should not be fully explained by other factors, such as effects of a substance or major changes in the patient's environment (Criterion D).

Conclusions: The new diagnostic criteria for apathy provide a clinical and scientific framework to increase the validity of apathy as a clinical construct. This should also help to pave the path for apathy in brain disorders to be an interventional target. (c) 2018 The Author(s). Published by Elsevier Masson SAS. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Original language	English
Pages (from-to)	71-76
Number of pages	6
Journal	European Psychiatry
Volume	54
DOIs	https://doi.org/10.1016/j.eurpsy.2018.07.008
Publication status	Published - Oct 2018

Keywords

Apathy
Neuropsychiatry
Brain disorders
Motivation
Behaviour
Emotion
Social interaction
Treatment
MILD COGNITIVE IMPAIRMENT
RATING-SCALE LARS
ALZHEIMERS-DISEASE
PARKINSONS-DISEASE
CLINICAL-PRACTICE
MOTOR-ACTIVITY
SYMPTOMS
MOTIVATION
METAANALYSIS
DEPRESSION

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Cite this

Robert, P., Lanctot, K. L., Aguera-Ortiz, L., Aalten, P., Bremond, F., Defrancesco, M., Hanon, C., David, R., Dubois, B., Dujardin, K., Husain, M., Konig, A., Levy, R., Mantua, V., Meulien, D., Miller, D., Moebius, H. J., Rasmussen, J., Robert, G., ... Manera, V. (2018). Is it time to revise the diagnostic criteria for apathy in brain disorders? The 2018 international consensus group. European Psychiatry, 54, 71-76. https://doi.org/10.1016/j.eurpsy.2018.07.008

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title = "Is it time to revise the diagnostic criteria for apathy in brain disorders? The 2018 international consensus group",

abstract = "Background: Apathy is a very common behavioural and psychological symptom across brain disorders. In the last decade, there have been considerable advances in research on apathy and motivation. It is thus important to revise the apathy diagnostic criteria published in 2009. The main objectives were to: a) revise the definition of apathy; b) update the list of apathy dimensions; c) operationalise the diagnostic criteria; and d) suggest appropriate assessment tools including new technologies.Methods: The expert panel (N = 23) included researchers and health care professionals working on brain disorders and apathy, a representative of a regulatory body, and a representative of the pharmaceutical industry. The revised diagnostic criteria for apathy were developed in a two-step process. First, following the standard Delphi methodology, the experts were asked to answer questions via web-survey in two rounds. Second, all the collected information was discussed on the occasion of the 26th European Congress of Psychiatry held in Nice (France).Results: Apathy was defined as a quantitative reduction of goal-directed activity in comparison to the patient's previous level of functioning (criterion A). Symptoms must persist for at least four weeks, and affect at least two of the three apathy dimensions (behaviour/cognition; emotion; social interaction; criterion B). Apathy should cause identifiable functional impairments (criterion C), and should not be fully explained by other factors, such as effects of a substance or major changes in the patient's environment (Criterion D).Conclusions: The new diagnostic criteria for apathy provide a clinical and scientific framework to increase the validity of apathy as a clinical construct. This should also help to pave the path for apathy in brain disorders to be an interventional target. (c) 2018 The Author(s). Published by Elsevier Masson SAS. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).",

keywords = "Apathy, Neuropsychiatry, Brain disorders, Motivation, Behaviour, Emotion, Social interaction, Treatment, MILD COGNITIVE IMPAIRMENT, RATING-SCALE LARS, ALZHEIMERS-DISEASE, PARKINSONS-DISEASE, CLINICAL-PRACTICE, MOTOR-ACTIVITY, SYMPTOMS, MOTIVATION, METAANALYSIS, DEPRESSION",

author = "P. Robert and Lanctot, {K. L.} and L. Aguera-Ortiz and P. Aalten and F. Bremond and M. Defrancesco and C. Hanon and R. David and B. Dubois and K. Dujardin and M. Husain and A. Konig and R. Levy and V. Mantua and D. Meulien and D. Miller and Moebius, {H. J.} and J. Rasmussen and G. Robert and M. Ruthirakuhan and F. Stella and J. Yesavage and R. Zeghari and V. Manera",

year = "2018",

month = oct,

doi = "10.1016/j.eurpsy.2018.07.008",

language = "English",

volume = "54",

pages = "71--76",

journal = "European Psychiatry",

issn = "0924-9338",

publisher = "Elsevier France-{\'E}ditions Scientifiques et Medicales Elsevier",

}

Robert, P, Lanctot, KL, Aguera-Ortiz, L, Aalten, P, Bremond, F, Defrancesco, M, Hanon, C, David, R, Dubois, B, Dujardin, K, Husain, M, Konig, A, Levy, R, Mantua, V, Meulien, D, Miller, D, Moebius, HJ, Rasmussen, J, Robert, G, Ruthirakuhan, M, Stella, F, Yesavage, J, Zeghari, R & Manera, V 2018, 'Is it time to revise the diagnostic criteria for apathy in brain disorders? The 2018 international consensus group', European Psychiatry, vol. 54, pp. 71-76. https://doi.org/10.1016/j.eurpsy.2018.07.008

TY - JOUR

T1 - Is it time to revise the diagnostic criteria for apathy in brain disorders? The 2018 international consensus group

AU - Robert, P.

AU - Lanctot, K. L.

AU - Aguera-Ortiz, L.

AU - Aalten, P.

AU - Bremond, F.

AU - Defrancesco, M.

AU - Hanon, C.

AU - David, R.

AU - Dubois, B.

AU - Dujardin, K.

AU - Husain, M.

AU - Konig, A.

AU - Levy, R.

AU - Mantua, V.

AU - Meulien, D.

AU - Miller, D.

AU - Moebius, H. J.

AU - Rasmussen, J.

AU - Robert, G.

AU - Ruthirakuhan, M.

AU - Stella, F.

AU - Yesavage, J.

AU - Zeghari, R.

AU - Manera, V.

PY - 2018/10

Y1 - 2018/10

N2 - Background: Apathy is a very common behavioural and psychological symptom across brain disorders. In the last decade, there have been considerable advances in research on apathy and motivation. It is thus important to revise the apathy diagnostic criteria published in 2009. The main objectives were to: a) revise the definition of apathy; b) update the list of apathy dimensions; c) operationalise the diagnostic criteria; and d) suggest appropriate assessment tools including new technologies.Methods: The expert panel (N = 23) included researchers and health care professionals working on brain disorders and apathy, a representative of a regulatory body, and a representative of the pharmaceutical industry. The revised diagnostic criteria for apathy were developed in a two-step process. First, following the standard Delphi methodology, the experts were asked to answer questions via web-survey in two rounds. Second, all the collected information was discussed on the occasion of the 26th European Congress of Psychiatry held in Nice (France).Results: Apathy was defined as a quantitative reduction of goal-directed activity in comparison to the patient's previous level of functioning (criterion A). Symptoms must persist for at least four weeks, and affect at least two of the three apathy dimensions (behaviour/cognition; emotion; social interaction; criterion B). Apathy should cause identifiable functional impairments (criterion C), and should not be fully explained by other factors, such as effects of a substance or major changes in the patient's environment (Criterion D).Conclusions: The new diagnostic criteria for apathy provide a clinical and scientific framework to increase the validity of apathy as a clinical construct. This should also help to pave the path for apathy in brain disorders to be an interventional target. (c) 2018 The Author(s). Published by Elsevier Masson SAS. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

AB - Background: Apathy is a very common behavioural and psychological symptom across brain disorders. In the last decade, there have been considerable advances in research on apathy and motivation. It is thus important to revise the apathy diagnostic criteria published in 2009. The main objectives were to: a) revise the definition of apathy; b) update the list of apathy dimensions; c) operationalise the diagnostic criteria; and d) suggest appropriate assessment tools including new technologies.Methods: The expert panel (N = 23) included researchers and health care professionals working on brain disorders and apathy, a representative of a regulatory body, and a representative of the pharmaceutical industry. The revised diagnostic criteria for apathy were developed in a two-step process. First, following the standard Delphi methodology, the experts were asked to answer questions via web-survey in two rounds. Second, all the collected information was discussed on the occasion of the 26th European Congress of Psychiatry held in Nice (France).Results: Apathy was defined as a quantitative reduction of goal-directed activity in comparison to the patient's previous level of functioning (criterion A). Symptoms must persist for at least four weeks, and affect at least two of the three apathy dimensions (behaviour/cognition; emotion; social interaction; criterion B). Apathy should cause identifiable functional impairments (criterion C), and should not be fully explained by other factors, such as effects of a substance or major changes in the patient's environment (Criterion D).Conclusions: The new diagnostic criteria for apathy provide a clinical and scientific framework to increase the validity of apathy as a clinical construct. This should also help to pave the path for apathy in brain disorders to be an interventional target. (c) 2018 The Author(s). Published by Elsevier Masson SAS. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

KW - Apathy

KW - Neuropsychiatry

KW - Brain disorders

KW - Motivation

KW - Behaviour

KW - Emotion

KW - Social interaction

KW - Treatment

KW - MILD COGNITIVE IMPAIRMENT

KW - RATING-SCALE LARS

KW - ALZHEIMERS-DISEASE

KW - PARKINSONS-DISEASE

KW - CLINICAL-PRACTICE

KW - MOTOR-ACTIVITY

KW - SYMPTOMS

KW - MOTIVATION

KW - METAANALYSIS

KW - DEPRESSION

U2 - 10.1016/j.eurpsy.2018.07.008

DO - 10.1016/j.eurpsy.2018.07.008

M3 - Article

C2 - 30125783

SN - 0924-9338

VL - 54

SP - 71

EP - 76

JO - European Psychiatry

JF - European Psychiatry

ER -