The cognitive, affective motivational and clinical longitudinal determinants of apathy in schizophrenia

  • Stéphane RaffardEmail author
  • Catherine Bortolon
  • Hanan Yazbek
  • Christophe Lançon
  • Michel Benoit
  • Joanna Norton
  • Delphine Capdevielle
Original Paper


Apathy is a frequent and debilitating condition with few treatment options available in schizophrenia patients. Despite evidence of its multidimensional structure, most of past studies have explored apathy through a categorical approach. The main objective of this study was to identify the cognitive, emotional, motivational, and clinical factors at baseline that best predicted the three subtypes of apathy dimensions at follow-up. In a longitudinal study, 137 participants diagnosed with schizophrenia underwent different assessments including clinical, motivational, affective and cognitive measurements, at 1-month (referred to as baseline) and 12-month follow-ups. Data were analyzed using partial least squares variance-based structural equation modeling. Three latent variables representing the three previously described domains of apathy reaching consensus in the literature were extracted from the Lille Apathy Rating Scale. Results showed that in addition to baseline apathy, positive symptoms, anticipatory pleasure and sensibility to punishment at baseline predicted cognitive apathy at follow-up. Likewise, both baseline apathy and sensibility to punishment predicted emotional apathy at follow-up. Finally, baseline anhedonia and episodic memory were the main variables the predicted behavioral apathy at follow-up. This is the first study to show specific associations between apathy subtypes and clinical and cognitive motivational dysfunction in individual with schizophrenia, indicating possible distinct underlying mechanisms to these demotivational symptoms. Treatment for apathy should address both types of processes. Importantly, our results demonstrate the interest of multidimensional approaches in the understanding of apathy in schizophrenia.


Apathy Longitudinal study Negative symptoms Partial least squares-path modeling 



The study was financed by a University Hospital Clinical Research Grant, Montpellier (#UF8641), 2010. The University Hospital had no further role in the study design, in the collection, analysis and interpretation of data, in the writing of the report and in the decision to submit the article for publication.

Compliance with ethical standards

Conflict of interest

The authors have declared that there are no conflicts of interest in relation to the subject of this study.

Supplementary material

406_2018_907_MOESM1_ESM.docx (26 kb)
Supplementary material 1 (DOCX 25 KB)


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Authors and Affiliations

  1. 1.University Department of Adult PsychiatryHôpital de la Colombière, CHU MontpellierMontpellierFrance
  2. 2.Epsylon Laboratory EA 4556, Université Paul Valéry Montpellier 3Université MontpellierMontpellierFrance
  3. 3.INSERM U1061MontpellierFrance
  4. 4.University of MontpellierMontpellierFrance
  5. 5.Aix-Marseille Univ., EA 3279-Public Health, Chronic Diseases and Quality of Life-Research UnitMarseilleFrance
  6. 6.Psychiatry-Clinical Neuroscience DepartmentPasteur Hospital, University of Nice Sophia-AntipolisNiceFrance

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