Apathy in first episode psychosis patients: A ten year longitudinal follow-up study

Division of Mental Health and Addiction, Oslo University Hospital, N-0407, Oslo, Norway.
Schizophrenia Research (Impact Factor: 3.92). 04/2012; 136(1-3):19-24. DOI: 10.1016/j.schres.2011.12.019
Source: PubMed


Apathy is a common symptom in first episode psychosis (FEP), and is associated with poor functioning. Prevalence and correlates of apathy 10 years after the first psychotic episode remain unexplored.
The aims of the study were twofold: 1) to examine prevalence and predictors of apathy at 10 years, and 2) to examine the relationship between apathy at 10 years and concurrent symptoms, functioning and outcome, including subjective quality of life.
Three-hundred-and-one patients with FEP were included at baseline, 186 participated in the 10 year follow-up. Of these, 178 patients completed the Apathy Evaluation Scale (AES-S-Apathy). Patients were classified as having apathy (AES-S-Apathy≥27) or not. The relationship between apathy and baseline variables (Demographics, Diagnosis, Duration of Untreated Psychosis), measures of symptomatology (Positive and Negative Syndrome Scale, Calgary Depression Scale for Schizophrenia), functioning (Global Assessment of Functioning Scale, Strauss Carpenter Level of Functioning Scale) and subjective quality of life (Lehman's Quality of Life Interview) were estimated through correlation analyses and blockwise multiple hierarchical regression analysis.
Nearly 30% of patients met the threshold for being apathetic at follow-up. No baseline variables predicted apathy significantly at 10 years. Apathy was found to contribute independently to functioning and subjective quality of life, even when controlling for other significant correlates.
Apathy is a common symptom in a FEP cohort 10 years after illness debut, and its presence relates to impaired functioning and poorer subjective quality of life.

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Available from: Svein Friis, Oct 12, 2015
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    • "All versions of AES are brief and easy to complete, provide a quantitative assessment of general loss of motivation, and also include three specific subscores relative to cognitive, behavioral, and emotional aspects of apathy. These characteristics make AES particularly suitable for assessing changes in the manifestation of apathy over time and in response to specific treatment [24] [25]. However, applicability of AES in MS has not been tested yet. "
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    ABSTRACT: Results AES-S was easy to administer and acceptable, and showed fair internal consistency (Cronbach's alpha, α = 0.87). The factorial analysis identified three factors, representing the cognitive dimension (α = 0.87), a general aspect of apathy (α = 0.84), and the behavioral-emotional aspects (α = 0.74), respectively. The factors were significantly correlated with the total AES score (all rrho ≥ 0.73, p < 0.001). The total AES score showed fair convergent validity (rrho = 0.38) and discriminant validity when compared to Expanded Disability Status Scale (rrho = 0.38), Mini Mental State Examination (rrho = - 0.17), and Hamilton Depression Rating Scale (rrho = 0.37). Receiver-operating characteristic curve analysis demonstrated that a cutoff > 35.5 can identify clinically significant apathy with good sensitivity (88%) and specificity (72%); such a cutoff identified apathy in 35.7% of our sample of non-demented MS patients. Total AES score was significantly correlated with reduced global cognitive efficiency and more severe frontal executive dysfunctions.
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