Diagnostic criteria for apathy in clinical practice
Identifieur interne : 000341 ( Main/Exploration ); précédent : 000340; suivant : 000342Diagnostic criteria for apathy in clinical practice
Auteurs : E. Mulin [France] ; E. Leone [France] ; K. Dujardin [France] ; M. Delliaux [France] ; A. Leentjens [Pays-Bas] ; F. Nobili [Italie] ; B. Dessi [Italie] ; O. Tible [France] ; L. Agüera-Ortiz [Espagne] ; R. S. Osorio [Espagne] ; J. Yessavage [États-Unis] ; D. Dachevsky [Argentine] ; F. Rj. Verhey [Pays-Bas] ; Alfonso J. Cruz Jentoft [Espagne] ; O. Blanc [France] ; P. M Llorca [France] ; P. H. Robert [France]Source :
- International Journal of Geriatric Psychiatry [ 0885-6230 ] ; 2011-02.
English descriptors
- KwdEn :
Abstract
Background: Apathy is an important and distressing behavioural symptom in Alzheimer's disease and in various neuropsychiatric disorders. Recently, diagnostic criteria for apathy have been proposed. Objectives: In groups of patients suffering from different neuropsychiatric diseases, (i) to estimate the prevalence of patients meeting the proposed diagnostic criteria; (ii) to estimate the concurrent validity of the criteria with the neuropsychiatric inventory (NPI) apathy item; (iii) to identify the most frequently met criteria or sub‐criteria in each specific neuropsychiatric disease and (iv) to estimate the inter‐observer reliability of the diagnostic criteria for apathy. Methods: This cross‐sectional, multicentric, observational study was performed on 306 patients. Each of the participating centres had to check the presence of apathy according to the diagnostic criteria for apathy in consecutive patients belonging to the following diagnoses list: Alzheimer disease (AD), mixed dementia, mild cognitive impairment (MCI), Parkinson's disease (PD), Schizophrenia (DSM‐IV) and major depressive episode. In addition to the clinical interview, the assessment included the Mini Mental Score Examination (MMSE) and the NPI. At the end of the visit, clinicians were required to check the diagnostic criteria for apathy. Results: Using the diagnostic criteria for apathy, the frequency of apathy was of 53% in the whole population, 55% in AD, 70% in mixed dementia, 43% in MCI, 27% in PD, 53% in schizophrenia and 94% in major depressive episode. In AD, mixed dementia, MCI and PD, the NPI apathy score was significantly higher for patient fulfilling the apathy criteria. Goal‐directed cognitive activity (criteria B2‐Cognition) was the most frequently observed domain followed by goal‐directed behaviour (criteria B1—Behaviour) and emotion (criteria B3), respectively. Inter‐rater reliability was high for the overall diagnostic (κ coefficient = 0.93; p = 0.0001) and for each criteria. Conclusion: This study is the first one to test the diagnostic criteria for apathy in clinical practice. Results make the diagnostic criteria useful for clinical practice and research. Copyright © 2010 John Wiley & Sons, Ltd.
Url:
DOI: 10.1002/gps.2508
Affiliations:
- Argentine, Espagne, France, Italie, Pays-Bas, États-Unis
- Californie, Communauté de Madrid
- Lille, Madrid
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Agüera-Ortiz</name><affiliation wicri:level="3"><country xml:lang="fr">Espagne</country><wicri:regionArea>Alzheimer Project Research Unit, Cien & Reina Sofia Foundation, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Osorio, R S" sort="Osorio, R S" uniqKey="Osorio R" first="R. S." last="Osorio">R. S. Osorio</name><affiliation wicri:level="3"><country xml:lang="fr">Espagne</country><wicri:regionArea>Alzheimer Project Research Unit, Cien & Reina Sofia Foundation, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Yessavage, J" sort="Yessavage, J" uniqKey="Yessavage J" first="J." last="Yessavage">J. Yessavage</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Sierra‐Pacific Mental Illness Research, Education, and Clinical Center, Palo Alto VA Health Care System, CA</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, CA</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Dachevsky, D" sort="Dachevsky, D" uniqKey="Dachevsky D" first="D." last="Dachevsky">D. Dachevsky</name><affiliation wicri:level="1"><country xml:lang="fr">Argentine</country><wicri:regionArea>Department of Psychiatry; National University Rosario</wicri:regionArea></affiliation></author><author><name sortKey="Verhey, F Rj" sort="Verhey, F Rj" uniqKey="Verhey F" first="F. Rj." last="Verhey">F. Rj. Verhey</name><affiliation wicri:level="1"><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Maastricht University Medical Center/ Alzheimer Centre Limburg</wicri:regionArea></affiliation></author><author><name sortKey="Jentoft, Alfonso J Cruz" sort="Jentoft, Alfonso J Cruz" uniqKey="Jentoft A" first="Alfonso J. Cruz" last="Jentoft">Alfonso J. Cruz Jentoft</name><affiliation wicri:level="3"><country xml:lang="fr">Espagne</country><wicri:regionArea>Servicio de Geriatría, Hospital Universitario Ramón y Cajal, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Blanc, O" sort="Blanc, O" uniqKey="Blanc O" first="O." last="Blanc">O. Blanc</name><affiliation wicri:level="1"><country xml:lang="fr">France</country><wicri:regionArea>Université d'Auvergne, CHU Clermont‐Ferrand</wicri:regionArea><wicri:noRegion>CHU Clermont‐Ferrand</wicri:noRegion><wicri:noRegion>CHU Clermont‐Ferrand</wicri:noRegion></affiliation></author><author><name sortKey="Llorca, P M" sort="Llorca, P M" uniqKey="Llorca P" first="P. M" last="Llorca">P. M Llorca</name><affiliation wicri:level="1"><country xml:lang="fr">France</country><wicri:regionArea>Université d'Auvergne, CHU Clermont‐Ferrand</wicri:regionArea><wicri:noRegion>CHU Clermont‐Ferrand</wicri:noRegion><wicri:noRegion>CHU Clermont‐Ferrand</wicri:noRegion></affiliation></author><author><name sortKey="Robert, P H" sort="Robert, P H" uniqKey="Robert P" first="P. H." last="Robert">P. H. Robert</name><affiliation wicri:level="1"><country xml:lang="fr">France</country><wicri:regionArea>Centre Mémoire de Ressources et de Recherche, CHU, Université de Nice Sophia, Antipolis</wicri:regionArea><wicri:noRegion>Antipolis</wicri:noRegion><wicri:noRegion>Antipolis</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j">International Journal of Geriatric Psychiatry</title><title level="j" type="abbrev">Int. J. Geriat. Psychiatry</title><idno type="ISSN">0885-6230</idno><idno type="eISSN">1099-1166</idno><imprint><publisher>John Wiley & Sons, Ltd.</publisher><pubPlace>Chichester, UK</pubPlace><date type="published" when="2011-02">2011-02</date><biblScope unit="volume">26</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="158">158</biblScope><biblScope unit="page" to="165">165</biblScope></imprint><idno type="ISSN">0885-6230</idno></series><idno type="istex">809D1EED246CBF5A2BC103F9DEC7E127BCF87954</idno><idno type="DOI">10.1002/gps.2508</idno><idno type="ArticleID">GPS2508</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-6230</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Alzheimer's disease</term><term>apathy</term><term>dementia</term><term>diagnostic criteria</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background: Apathy is an important and distressing behavioural symptom in Alzheimer's disease and in various neuropsychiatric disorders. Recently, diagnostic criteria for apathy have been proposed. Objectives: In groups of patients suffering from different neuropsychiatric diseases, (i) to estimate the prevalence of patients meeting the proposed diagnostic criteria; (ii) to estimate the concurrent validity of the criteria with the neuropsychiatric inventory (NPI) apathy item; (iii) to identify the most frequently met criteria or sub‐criteria in each specific neuropsychiatric disease and (iv) to estimate the inter‐observer reliability of the diagnostic criteria for apathy. Methods: This cross‐sectional, multicentric, observational study was performed on 306 patients. Each of the participating centres had to check the presence of apathy according to the diagnostic criteria for apathy in consecutive patients belonging to the following diagnoses list: Alzheimer disease (AD), mixed dementia, mild cognitive impairment (MCI), Parkinson's disease (PD), Schizophrenia (DSM‐IV) and major depressive episode. In addition to the clinical interview, the assessment included the Mini Mental Score Examination (MMSE) and the NPI. At the end of the visit, clinicians were required to check the diagnostic criteria for apathy. Results: Using the diagnostic criteria for apathy, the frequency of apathy was of 53% in the whole population, 55% in AD, 70% in mixed dementia, 43% in MCI, 27% in PD, 53% in schizophrenia and 94% in major depressive episode. In AD, mixed dementia, MCI and PD, the NPI apathy score was significantly higher for patient fulfilling the apathy criteria. Goal‐directed cognitive activity (criteria B2‐Cognition) was the most frequently observed domain followed by goal‐directed behaviour (criteria B1—Behaviour) and emotion (criteria B3), respectively. Inter‐rater reliability was high for the overall diagnostic (κ coefficient = 0.93; p = 0.0001) and for each criteria. Conclusion: This study is the first one to test the diagnostic criteria for apathy in clinical practice. Results make the diagnostic criteria useful for clinical practice and research. Copyright © 2010 John Wiley & Sons, Ltd.</div></front></TEI><affiliations><list><country><li>Argentine</li><li>Espagne</li><li>France</li><li>Italie</li><li>Pays-Bas</li><li>États-Unis</li></country><region><li>Californie</li><li>Communauté de Madrid</li></region><settlement><li>Lille</li><li>Madrid</li></settlement></list><tree><country name="France"><noRegion><name sortKey="Mulin, E" sort="Mulin, E" uniqKey="Mulin E" first="E." last="Mulin">E. Mulin</name></noRegion><name sortKey="Blanc, O" sort="Blanc, O" uniqKey="Blanc O" first="O." last="Blanc">O. Blanc</name><name sortKey="Delliaux, M" sort="Delliaux, M" uniqKey="Delliaux M" first="M." last="Delliaux">M. Delliaux</name><name sortKey="Dujardin, K" sort="Dujardin, K" uniqKey="Dujardin K" first="K." last="Dujardin">K. Dujardin</name><name sortKey="Leone, E" sort="Leone, E" uniqKey="Leone E" first="E." last="Leone">E. Leone</name><name sortKey="Llorca, P M" sort="Llorca, P M" uniqKey="Llorca P" first="P. M" last="Llorca">P. M Llorca</name><name sortKey="Robert, P H" sort="Robert, P H" uniqKey="Robert P" first="P. H." last="Robert">P. H. Robert</name><name sortKey="Tible, O" sort="Tible, O" uniqKey="Tible O" first="O." last="Tible">O. Tible</name></country><country name="Pays-Bas"><noRegion><name sortKey="Leentjens, A" sort="Leentjens, A" uniqKey="Leentjens A" first="A." last="Leentjens">A. Leentjens</name></noRegion><name sortKey="Verhey, F Rj" sort="Verhey, F Rj" uniqKey="Verhey F" first="F. Rj." last="Verhey">F. Rj. Verhey</name></country><country name="Italie"><noRegion><name sortKey="Nobili, F" sort="Nobili, F" uniqKey="Nobili F" first="F." last="Nobili">F. Nobili</name></noRegion><name sortKey="Dessi, B" sort="Dessi, B" uniqKey="Dessi B" first="B." last="Dessi">B. Dessi</name></country><country name="Espagne"><region name="Communauté de Madrid"><name sortKey="Aguera Rtiz, L" sort="Aguera Rtiz, L" uniqKey="Aguera Rtiz L" first="L." last="Agüera-Ortiz">L. Agüera-Ortiz</name></region><name sortKey="Jentoft, Alfonso J Cruz" sort="Jentoft, Alfonso J Cruz" uniqKey="Jentoft A" first="Alfonso J. Cruz" last="Jentoft">Alfonso J. Cruz Jentoft</name><name sortKey="Osorio, R S" sort="Osorio, R S" uniqKey="Osorio R" first="R. S." last="Osorio">R. S. Osorio</name></country><country name="États-Unis"><region name="Californie"><name sortKey="Yessavage, J" sort="Yessavage, J" uniqKey="Yessavage J" first="J." last="Yessavage">J. Yessavage</name></region><name sortKey="Yessavage, J" sort="Yessavage, J" uniqKey="Yessavage J" first="J." last="Yessavage">J. Yessavage</name></country><country name="Argentine"><noRegion><name sortKey="Dachevsky, D" sort="Dachevsky, D" uniqKey="Dachevsky D" first="D." last="Dachevsky">D. 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