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Query: UMLS:C0085632 (apathy)
 4,089 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study investigated the nature of factor structure of schizophrenia syndromes using a sample of 151 patients with schizophrenia according to DSM-IV. The patients were assessed on the Scale for the Assessment of Positive Symptoms (SAPS), the Scale for the Assessment of Negative Symptoms (SANS), Hamilton Depression Rating Scale (HDRS) and the Phillips Rating Scale of Premorbid Adjustment in schizophrenia. Three factors-negative syndrome, reality-distortion syndrome and disorganized syndrome were extracted when only SAPS and SANS were analysed. Addition of the Phillips Rating Scale scores to SAPS and SANS ratings in the factorial equation led to splitting of the negative syndrome though reality-distortion and disorganized syndromes remained stable. Factor analysis of the HDRS scores with SAPS and SANS ratings resulted in the HDRS loading highly on reality-distortion syndrome and splitting of negative syndrome. Factor analysis of all the variables taken together resulted in delineation of four factors. The study suggests a link between depression and reality distortion. Apathy and anhedonia seem to be linked to premorbid adjustment.
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PMID:Influence of depressive symptoms and premorbid adjustment on factor structure of phenomenology of schizophrenia: a study from India. 1292 23

Little is known about the effects of recurring depressive episodes on cognition and behavior. The objective of the study was to compare cognitive function and depression-related behavior between healthy female subjects and female outpatients with early-onset DSM-IV recurrent major depressive disorder and to investigate the effect of cumulative depressive duration. Neuropsychological tests and scales for apathy, anhedonia and psychomotor retardation were assessed in 23 female patients and 60 healthy age-matched female controls. Significantly higher levels of apathy, anhedonia and psychomotor retardation, and worse performance on tests of executive function were found in the patient group compared with the healthy controls. In the patient group, cumulative depression duration was not significantly correlated with cognitive function, apathy, anhedonia or psychomotor retardation. The deficits in executive function were not related to the actual level of depression. Mild executive dysfunction may be the effect of the illness process underlying recurrent depressive disorder. Repeated or extensive depressive episodes do not seem to additionally affect cognitive deficits or behavior in depressed patients.
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PMID:Effects of recurrent major depressive disorder on behavior and cognitive function in female depressed patients. 1500 30

The Helsinki High-Risk (HR) Study is a follow-up study of 179 offspring born to mothers with DSM-IV-TR diagnoses of schizophrenia, schizoaffective disorder, other schizophrenia spectrum disorders, and affective psychoses. Mothers comprised all female patients born between 1916 and 1948 who had been treated with hospital diagnoses of schizophrenia, schizophreniform, or schizoaffective psychoses in any mental hospital in the city of Helsinki up to 1974, and who had given birth in Helsinki between 1960 and 1964. In this report we conducted a principal factor analysis of maternal symptoms using 12 items of the Major Symptoms of Schizophrenia Scale (MSSS), the global ratings of anhedonia-asociality and avolition-apathy from the Scale for the Assessment of Negative Symptoms (SANS), and the global rating of bizarre behavior from the Scale for the Assessment of Positive symptoms (SAPS), and examined whether the factor scores predicted the offspring's morbidity from psychotic disorders. We found a four-factor solution (negative, positive, catatonic, and affective symptom factors). High maternal positive symptom factor score significantly predicted decreased morbidity from schizophrenia among offspring (P=0.0098). Our result suggests that maternal positive symptoms are less harmful to the child than other maternal psychotic symptoms, and supports the view that positive symptoms are non-specific symptoms of psychosis rather than core features of schizophrenia.
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PMID:Do maternal psychotic symptoms predict offspring's psychotic disorder? Findings from the Helsinki High-Risk Study. 1500 34

The development of therapeutic strategies to effectively treat negative symptoms remains one of the primary goals in the treatment of schizophrenia. Mirtazapine is the first of a new class of dual action compounds, the noradrenergic and specific serotonergic antidepressants (NaSSa), whose activity is related to the enhancement of noradrenergic and serotonergic transmission by a presynaptic alpha2 antagonism and postsynaptic 5-HT2 and 5-HT3 antagonism, respectively. This study was a 8-week double-blind, randomized, placebo-controlled trial of 30 mg adjunctive mirtazapine to clozapine therapy in 24 patients with DSM-IV schizophrenia. The main finding at the end of the trial was a significant reduction on the Scale for the Assessment of Negative Symptoms (SANS) total scores in the mirtazapine group compared to placebo (P<0.01) with a significant improvement on the SANS subscales avolition/apathy and anhedonia/asociality. The Brief Psychiatric Rating Scale total score at week 8 showed superiority of mirtazapine over placebo. These findings suggest a potential role for mirtazapine as an augmentation strategy in the treatment of negative symptoms of schizophrenia.
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PMID:The effect of mirtazapine augmentation of clozapine in the treatment of negative symptoms of schizophrenia: a double-blind, placebo-controlled study. 1507 14

The symptoms of major psychosis aggregate in factors. Models of one to eight dimensions have been reported. In the present study, we tested six competing factor models, based on the psychotic and affective items of the OPCRIT checklist, in a large sample (N = 1294) of patients diagnosed with DSM-IV schizophrenia (n = 460), bipolar disorder (n = 726) and delusional disorder (n = 108). Confirmatory factor analysis was used to test the following models: (1) unique psychotic dimension; (2) positive-manic items, negative-depressive items; (3) model 2 with the addition of a disorganized factor; (4A) positive, negative, depressive and manic dimensions; (4B) model 4A with loss of pleasure (Anhedonia) and loss of energy (Apathy) included among depressive instead of negative symptoms; and (5) same as model 4B except for the addition of a disorganized domain. The four- and five-factor models fit the data much better than simpler ones. Between the two four-factor models, M4B emerged as more appropriate than M4A. The five-factor solution (M5) displayed the best fit. In conclusion, our confirmatory factor analysis in a large sample of psychotic subjects indicated that the symptomatology of major psychoses is composed of the following five factors: mania, positive symptoms, disorganization, depression and negative symptoms.
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PMID:Dimensions of major psychoses: a confirmatory factor analysis of six competing models. 1526 9

Clinical expressions of cognition and behaviour in Alzheimer's disease (AD) patients are heterogeneous. Therefore, assessing the entire range of selective cognitive and behavioural characteristics of dementia in minute detail is extremely important. However, considering that groups of different symptoms may respond to the same pharmacological agent, it is also evident that a correct evaluation of the behaviour requires the grouping of symptoms in fewer syndromes. Thus, the authors have analysed various connections between selective cognitive domains and behavioural symptoms (BPSD) in probable AD outpatients. Two hundred and forty four patients with diagnosis of probable AD, according to DSM-IV and NINCDS-ADRDA criteria were enrolled. The evaluation included the Mini Mental State Examination, the Mental Deterioration Battery, and the Neuropsychiatric Inventory. Treatment with low doses of neuroleptic drugs only was allowed. Principal component analysis condensed the 18 cognitive/behavioural variables in 7 factors namely general-cognitive, constructional abilities, hyperactivity, psychosis, anxiety, mood-excitement and mood-depression/apathy. None of the cognitive domains were included in the behavioural factors and vice-versa. Furthermore, the only BPSD which impaired continuously with progression of disease severity was apathy which was also the most severe symptom. In conclusion, many cognitive and behavioural syndromes exist in patients with AD. However, the results of this study suggest that cognition and behaviour are independent dimensions.
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PMID:Cognition and behaviour are independent and heterogeneous dimensions in Alzheimer's disease. 1531 44

The objective of this study was to examine the validity of the mentation, behavior, and mood items included in Part I of the Unified Parkinson's Disease Rating Scale (UPDRS) and to assess its usefulness to screen for dementia, psychosis, depression, and apathy. A consecutive series of 168 patients with PD were assessed by neurologists with the UPDRS, and by psychiatrists using a comprehensive neuropsychiatric evaluation blind to each other's ratings. ROC analysis demonstrated that a score of 2 or greater on the intellectual impairment item of the UPDRS had 60% sensitivity and 92% specificity to detect dementia, as diagnosed with DSM-IV criteria. When a score of 23 or lower on the MMSE was included as an additional classification variable, the sensitivity increased to 85%. A score of 2 or greater on the thought disorder item had 43% sensitivity and 92% specificity to detect psychotic symptoms (delusions or hallucinations). A score of 2 or greater on the depression item had 77% sensitivity and 82% specificity to detect major depression as diagnosed with DSM-IV criteria. Finally, a score of 2 or greater on the motivation/initiative item had 73% sensitivity and 65% specificity to detect apathy, as diagnosed with a standardized criteria. When the sample was divided into mild (i.e. Hohen-Yahr stages I and II) versus moderate-severe PD (i.e. Hohen-Yahr stages III-V), findings remained unchanged, except that the UPDRS show unacceptably low accuracy to detect psychosis in mild PD. The mentation, behavior, and mood section of the UPDRS is an adequate screen for depression and apathy, and has adequate sensitivity to detect dementia when combined with the Mini-Mental State Exam, but has low sensitivity to detect psychosis.
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PMID:The Unified Parkinson's Disease Rating Scale: validation study of the mentation, behavior, and mood section. 1772 77

Although Parkinson disease (PD) is primarily a condition of motor symptoms, an increasing amount of research has indicated that non-motor symptoms including cognitive and emotional deficits are observed even in the earliest stage of the disease. Individuals with PD may display various psychiatric and/or behavioural problems, among which depression and apathy are the most prominent symptoms. Prevalence of comorbid depression in PD has reportedly been estimated to be 7-76%. Such marked differences in the prevalence is partially attributable to different diagnostic criteria. It is useful to make a diagnosis according to standardized semi-structured diagnostic interview following DSM-IV or ICD-10. Based on such diagnostic criteria, prevalence of depression may approximate 20-40%. A half of such individuals fulfill the criteria of major depressive disorder while remaining half may be diagnosed as having dysthymia, minor depression or apathy. The second reason contributing to diversity of prevalence of depression in PD is a sampling procedure. Prevalence of depression in PD is much lower in the community-based surveys than those examined recruited patients. The third reason which makes the diagnosis of depression in PD difficult is an approach how to treat ambiguous symptoms. Caution should be paid whether the researcher is taking an inclusive or exclusive approach while they diagnose depression in PD. Concerning apathy in PD, one should be aware that typical apathy syndrome is quite different from depressive mood state. Rather, apathy syndrome is on the opposite side of depression in the sense that the former lacks serious self reproach or feeling of guilty. Neural substrate of apathy is known to include the dorsolateral, medial and orbital frontal cortices, and subcortical structures such as the basal ganglia, thalamus and internal capsule. Future researches are warranted that discriminate neural correlates and/or chemical neurotransmitters between depression and apathy.
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PMID:[Depression and apathy in Parkinson disease]. 1788 75

Depression is a common psychiatric disorder, characterized by a persistent lowering of mood, loss of interest in routine activities and diminished ability to experience pleasure. There are several depression classification systems and diagnostic tools based on clinical symptoms, i.e. the International Classification of Diseases (ICD-10), the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), the Hamilton Depression Rating Scale, the Montgomery-Asberg Scale and Beck's Depression Inventory. Depression frequently occurs in patients with heart failure, as similar pathophysiological mechanisms of neurohormonal activation, arrhythmia, inflammation and hypercoagulation are present in both these diseases. Prognosis in patients with depression is also affected by insufficient cooperation between a patient and his doctor as regards the lifestyle and medication intake of a patient. Depression is usually accompanied by remission and relapse periods which might be related to the current heart failure status of a patient and despite intensive medical treatment they may recur. Depression is often difficult to diagnose or even left undiagnosed and thus untreated, because its symptoms: fatigue, apathy and decreased exercise tolerance, are common in the general population. Furthermore, safety and efficacy of antidepressant therapy in patients with cardiovascular diseases are not well established. Evidence from clinical trials evaluating the influence of depression behavioral and pharmacological treatment on morbidity and mortality in patients with heart failure is also limited. Taking into account that depression affects prognosis in patients with variety of disorders and common pathological mechanisms present both in depression and heart failure, screening tests for depression should be considered not only in patients with diagnosed heart failure but also those at risk of heart failure development.
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PMID:Is depression a problem in patients with chronic heart failure? 1840 73

Depressed patients draw small figures in the left upper corner of sheet in House-Tree-Person (H-T-P) Test. This type of drawing rarely was drawn by patients without melancholic complains. In the Crisis Intervention Department at the Budapest Social Center (Hungary), 5 homeless male patients between 42-67 years of ages were found with depressive type of drawing in the H-T-P Test, but without melancholy. One had alcoholic encephalopathy with mild cognitive disorder, four had alcoholic or vascular types of dementia. Three had severe apathy. One was euphoric, undiscriminating with logorhea, but reported depression without sadness in Beck Depression Inventory. One had retarded thinking. Psycho-organic signs were well demonstrated in demented patients' drawings. Four patients represented human figures without hands, which symbolized helplessness. Apathy frequently was reported to be the only syndrome in psycho-organic, chronic fatigue, burn out syndromes, or even in exhaustive depression and sickness-behaviour, but it could not be classified in ICD-10 or DSM-IV-TR. Apathy, like depression, responded to antidepressive treatments, therefore, this similarity of syndromes could be responsible for our lethargic patients' depressive type of drawings. Furthermore, clinically abortive depressions perhaps could be demonstrated only by nonverbal drawing test. Psycho-organic and depressive signs of drawings were reported to be independent of each other, therefore, dementia could not cause our patients' depressive type of drawings. So, H-T-P Drawing Test was a useful nonverbal method of psycho-organic patients' investigation, which demonstrated depression in patients without verbally manifest melancholic illness.
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PMID:[Depressive type of drawing test without melancholy]. 1895 20


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