%0 Journal Article
%T Poor Dissociation of Patient-Evaluated Apathy and Depressive Symptoms
%A Progress Njomboro
%A Shoumitro Deb
%J Current Gerontology and Geriatrics Research
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/846075
%X Apathy has traditionally been conceptualised as part of depression. The appropriateness of this conceptualisation has now been questioned, with the realization that apathy constitutes a distinct neuropsychiatric condition, with separate rehabilitation and patient-care implications to depression. Research on the relationship between apathy and depression has, however, produced mixed results. One reason for this inconsistency may lie behind who does the apathy evaluation. In this study we investigated whether the relationship between apathy and depression would differ when apathy was evaluated by the patients or an informant. A total of 49 brain damaged patients were assessed on self- and informant-rated Apathy Evaluation Scales. The relationship between the apathy scores and depressive symptoms was then investigated. Patient-rated, and not informant-rated apathy significantly correlated with depression. We discuss the implication of these results on the relationship between the two neuropsychiatric conditions and also in relation to the utility of patient self-evaluations in apathy. 1. Introduction The position of apathy as a distinct syndrome in both clinical practice and research is still uncertain and less clearly defined. Generally, apathy is conceptualised as constituting a significant loss of motivation [1]. For diagnostic purposes, this loss of motivation must be present for at least four weeks and should manifest in at least two of three dimensions of apathy involving reduced overt acts, cognitive activity, and affective responses related to goal directed behaviour [2]. The clinical importance of apathy is demonstrated through its association with reduced patient independence, social integration, rehabilitation success, and increased caregiver burden [3] and its high prevalence in patients suffering neurological change [4]. For instance, incidence of between 17¨C70% has been reported in Parkinson¡¯s disease [5, 6], and incidence of between 46 and 71% has been reported in patients with traumatic brain injury [7, 8]. Similar high incidence rates have been reported in Alzheimer¡¯s disease, frontotemporal dementia, progressive supranuclear palsy, and stroke [9¨C11]. See also [12] for a review. Much of the debate on apathy in the past decade has focused on its nosological position, particularly its relation to depressive symptoms [6, 13¨C16]. Traditionally, apathy has been viewed as a symptom of depression. Clinically, the two disorders are related in that they significantly overlap on symptom dimensions related to loss of interest, anhedonia, and reduced
%U http://www.hindawi.com/journals/cggr/2012/846075/