E. Fernandez-Egea, United Kingdom
University of Cambridge Department of PsychiatryModerator of 2 Sessions
Proposed by the EPA Section on Schizophrenia -Apathy as a negative symptom of schizophrenia is conceptualized in terms of reduction of goal directed behavior due to a lack of interest and motivation for goal-directed behavior initiation and persistence. The revised diagnostic criteria for apathy (DCA) have been proposed for trans-diagnostic use to better identify apathy across a number of neuropsychiatric disorders. The Section workshop aims to illustrate and discuss the overlap and specificity of apathy in schizophrenia with the trans-diagnostic construct identified by using the DCA. A European study on apathy in schizophrenia will be illustrated and preliminary findings reviewed to highlight the limitations of apathy as defined by the DCA in the context of schizophrenia. The relationships of apathy defined using DCA with the negative symptom domain of Avolition in schizophrenia and its overlap with functional impairment due to cognitive deficits/ depression/ extrapyramidal side effects will be discussed. Data in first-episode patients with schizophrenia will be reviewed to illustrate how the negative symptom domains and cognitive impairment are key factors in the prediction of long-term impairment in real-life functioning. Finally, the therapeutic perspectives for the treatment of apathy in schizophrenia, both when primary to the disorder process or secondary to other dimensions of schizophrenia will be reviewed and discussed.
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Presenter of 2 Presentations
Live Q&A
, W0021 - Is Apathy a True Trans-diagnostic Construct? Preliminary Findings of the European Study on Apathy in Schizophrenia
, ABSTRACT
Abstract Body
Apathy is a quantitive reduction of goal-directed activity either in behavioural, cognitive, emotional or social dimension in comparison to the person’s previous level of functioning in these areas. Apathy is prevalent across many neurodegenerative, neurological, and psychiatric disorders. It represents the most common behavioural and psychological symptom in people with Alzheimer’s Disease and is often observed in Parkinson’s disease, vascular dementia, stroke, traumatic brain injury, amyotrophic lateral sclerosis/motor neuron disease, frontotemporal dementia, progressive supranuclear palsy, major depression, and schizophrenia. However, the definition and terminology employed to refer to apathy can vary in the context of different conditions and specialities and the diagnostic criteria have evolved. Additionally, the term apathy is employed to describe both a symptom and a syndrome. Indeed, little progress has been achieved in assessing the validity of the same construct across different disorders (eg. neurodegenerative disorders, schizophrenia or affective disorders).
In 2018, a new version of the diagnostic criteria for apathy (DCA) in neuropsychiatric disorders was published. The validity of this new consensus has yet to be assessed among all relevant populations, including schizophrenia. Six European centres (Naples, Geneve, Nice, Rennes, Barcelona, Cambridge) aimed to test the prevalence of apathy, measured with the 2018 DCA, in patients diagnosed with schizophrenia. As a second aim, we focused on the relationship between DCA and other measures of apathy and negative symptoms in schizophrenia (BNSS and PANSS).
In this talk, we will compare the preliminary findings of this pan-European study in schizophrenia patients with previous studies on neurodegenerative disorders.