Skip to main content
SpringerLink
Log in

Apathy in neurologic disorders

  • Published:
Current Psychiatry Reports Aims and scope Submit manuscript

Abstract

Recent research has greatly increased our understanding of the clinical phenomenology and etiology of apathy as a distinct clinical symptom and syndrome. Several rating scales have been developed that assist in making a diagnosis of apathy. Apathy has received increasing attention as an important source of functional disability that should be considered when assessing and treating patients with neurologic disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Marin RS: Apathy: a neuropsychiatric syndrome. J Neuropsychiatry Clin Neurosci 1991, 3:243–254.

    PubMed  CAS  Google Scholar 

  2. Starkstein SE, Federoff JP, Price TR, et al.: Apathy following cerebrovascular lesions. Stroke 1993, 24:1625–1630.

    PubMed  CAS  Google Scholar 

  3. Marin RS: Differential diagnosis of apathy and related disorders of diminished motivation. Psychiatr Ann 1997, 27:30–33.

    Google Scholar 

  4. Marin RS: Apathy—who cares? An introduction to apathy and related disorders of motivation. Psychiatric Annals 1997, 27:23.

    Google Scholar 

  5. Andersen S, Gundersen PM, Finset A: Emotional activation during therapeutic interaction in traumatic brain injury: effect of apathy, self-awareness and implications for rehabilitation. Brain Inj 1999, 13:393–404. This paper is importance lies in the fact that it is the first study that attempts to define the psychophysiologic underpinnings of apathy.

    Article  Google Scholar 

  6. Marin RS, Biedrzycki RC, Firinciogullari S: Reliability and validity of the Apathy Evaluation Scale. Psychiatry Res 1991, 38:143–162.

    Article  PubMed  CAS  Google Scholar 

  7. Cummings JL, Mega MS, Gray K, et al.: The Neuropsychiatric Inventory. Neurology 1994, 44:2306–2314.

    Google Scholar 

  8. Wood S, Cummings JL, Hsu MA, et al.: The use of the neuropsychiatric Inventory in nursing home residents. Characterization and measurement. Am J Geriatr Psychiatry 2000, 8:75–83.

    PubMed  CAS  Google Scholar 

  9. Levy ML, Cummings JL, Fairbanks LA, et al.: Apathy is not depression. J Neuropsychiatry Clin Neurosci. 1998, 10:314–319. This study strengthens the concept of apathy as a distinct syndromal disorder that is distinguishable from depression.

    PubMed  CAS  Google Scholar 

  10. Yamashita K, Iijima K, Kobayashi S: Relationship among activities of daily living, apathy, and subjective well-being in elderly people living alone in a rural town. Gerontology 1999, 45:279–282. This paper raises the importance of identifying apathy as a powerful predictor of the subject’s capacity to maintain autonomous living. This concept has increasing significance in a medical system that requires patients to self-manage their diseases in the community.

    Article  PubMed  CAS  Google Scholar 

  11. Kalivas PW, Churchill L, Kliteneck MA: The circuitry mediating the translation of motivational stimuli into adaptive motor responses. In Limbic Motor Circuits and Neuropsychiatry. Edited by Kalivas PW, Barnes CD. Boca Raton, FL: CRC Press; 1994.

    Google Scholar 

  12. Duffy JD: The neural substrates of motivation. Psychiatr Ann 1997, 27:24–29.

    Google Scholar 

  13. Hoehn-Saric R, Lipsey JR, McLeod DR: Apathy and indifference in patients on fluvoxamine and fluoxetine. J Clin Psychopharmacol 1990, 10:343–346.

    Article  PubMed  CAS  Google Scholar 

  14. Tatemichi TK, Desmond DW, Prohovnik I, et al.: Confusion and memory loss from capsular genu infarction. Neurology 1992, 42:1966–1979.

    PubMed  CAS  Google Scholar 

  15. Okada K, Kobayashi S, Yamagata S, et al.: Poststroke apathy and regional cerebral blood flow. Stroke 1997, 28:2437–441.

    PubMed  CAS  Google Scholar 

  16. Duffy JD: Apathy secondary to neurologic disease. Psychiatr Ann 1997, 27:39–43.

    Google Scholar 

  17. Benoit M, Dygai I, Migneco O, et al.: Behavioral and psychological symptoms in Alzheimer’s disease. Relation between apathy and regional cerebral perfusion. Dement Geriatr Cogn Disord 1999, 10:511–517. Provides the foundation for describing the pathophysiology of apathy in Alzheimer’s disease.

    Article  PubMed  CAS  Google Scholar 

  18. Kuzis G, Sabe L, Tibert C, et al.: Neuropsychological correlates of apathy and depression in patients with dementia. Neurology 1999, 52:403–1407.

    Google Scholar 

  19. Starkstein SE, Mayberg HS, Preziosi TJ, et al.: Reliability, validity, and clinical correlates of apathy in Parkinson’s disease. J Neuropsychiatry Clin Neurosci 1992, 4:134–139.

    PubMed  CAS  Google Scholar 

  20. Aarsland D, Larsen JP, Lim NG, et al.: Range of neuropsychiatric disturbances in patients with Parkinson’s disease. J Neurol Neurosurg Psychiatry 1999, 67:492–496.

    PubMed  CAS  Google Scholar 

  21. Diaz-Olavarrieta C, Cummings JL, Velazquez J, et al.: Neuropsychiatric manifestations of multiple sclerosis. J Neuropsychiatry Clin Neurosci 1999, 11:51–58.

    PubMed  CAS  Google Scholar 

  22. Kant R, Duffy JD, Pivovarnik A.: Apathy following closed head injury. Brain Inj 1998, 12:87–92. In addition to describing the epidemiology of apathy in closed head injury, this study also highlights the functional consequences of apathy.

    Article  PubMed  CAS  Google Scholar 

  23. Castellon SA, Hinkin CH, Wood S, et al.: Apathy, depression, and cognitive performance in HIV-1 infection. J Neuropsychiatry Clin Neurosci 1998, 10:320–329. This study highlights the importance of identifying apathy as an important marker for HIV encephalopathy. Highlights the important distinction between depression and apathy in HIV-1 seropositive subjects.

    PubMed  CAS  Google Scholar 

  24. Okada S, Yamanouchi N, Kodama K, et al.: Regional cerebral blood flow abnormalities in chronic solvent abusers. Psychiatry Clin Neurosci 1999, 53:351–356.

    Article  PubMed  CAS  Google Scholar 

  25. Litvan I, Cummings JL, Mega M: Neuropsychiatric features of corticobasal degeneration. J Neurol Neurosurg Psychiatry 1998, 65:717–721.

    Article  PubMed  CAS  Google Scholar 

  26. McConnell H, Snyder P, Duffy JD: Behavioral effects of felbamate. J Neuropsychiatry Clin Neurosci 1996, 8:341–347.

    PubMed  CAS  Google Scholar 

  27. Campbell JJ, Duffy JD: Treatment strategies in amotivated patients. Psychiatr Ann 1997, 27:44–49.

    Google Scholar 

  28. Kaufer D: Beyond the cholinergic hypothesis: the effect of metrifonate and other cholinesterase inhibitors on neuropsychiatric symptoms in Alzheimer’s disease. Dement Geriatr Cogn Disord 1998, 9:8–14.

    Article  PubMed  CAS  Google Scholar 

  29. Cummings JL: Cholinesterase inhibitors: A new class of psychotropic compounds. Am J Psychiatry 2000, 157:4–15. Provides a comprehensive overview of the neurobehavioral effects of cholinesterase inhibitors.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Psychiatric Consultation Services, University of Connecticut School of Medicine, Hartford Hospital, 80 Seymour Street, 06102, Hartford, CT, USA

    James Duffy MD, ChB

Authors
  1. James Duffy MD, ChB
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Duffy, J. Apathy in neurologic disorders. Curr Psychiatry Rep 2, 434–439 (2000). https://doi.org/10.1007/s11920-000-0029-z

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11920-000-0029-z

Keywords

Search

Navigation