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Diagnostic criteria for apathy in clinical practice
1Centre Mémoire de Ressources et de Recherche, CHU, Université de Nice Sophia, Antipolis, France.
This study validates new diagnostic criteria for apathy, finding it prevalent across various neuropsychiatric disorders like Alzheimer's disease and major depressive episodes. The criteria demonstrate high reliability and clinical utility for research and practice.
Area of Science:
- Neuroscience
- Psychiatry
- Clinical Psychology
Background:
- Apathy is a significant behavioral symptom in Alzheimer's disease (AD) and other neuropsychiatric disorders.
- Recently proposed diagnostic criteria for apathy require validation in clinical settings.
Purpose of the Study:
- To estimate the prevalence of apathy using proposed diagnostic criteria across diverse neuropsychiatric conditions.
- To assess the concurrent validity of these criteria against the Neuropsychiatric Inventory (NPI) apathy item.
- To identify frequently met apathy sub-criteria and evaluate inter-observer reliability.
Main Methods:
- A cross-sectional, multicentric observational study involving 306 patients with Alzheimer's disease, mixed dementia, mild cognitive impairment (MCI), Parkinson's disease (PD), schizophrenia, and major depressive episodes.
- Assessments included clinical interviews, Mini Mental Score Examination (MMSE), and the NPI.
- Clinicians applied the proposed diagnostic criteria for apathy post-assessment.
Main Results:
- Overall apathy prevalence was 53%, with high rates in major depressive episode (94%), mixed dementia (70%), and AD (55%).
- Apathy criteria showed significant concurrent validity with the NPI apathy score in AD, mixed dementia, MCI, and PD.
- Goal-directed cognitive activity was the most frequently observed domain, followed by behavior and emotion.
- High inter-rater reliability (κ = 0.93) was observed for the overall diagnostic criteria and individual criteria.
Conclusions:
- This study provides the first clinical validation of proposed apathy diagnostic criteria.
- The findings support the utility of these criteria for both clinical practice and research in neuropsychiatric disorders.
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