Negative symptoms are present already during the first episode of psychosis and contribute significantly to functional decline. The limited progress in development of effective treatments for negative symptoms has prompted studies of the different symptoms making up the negative symptom complex, such as apathy. The aim of this thesis was to gain more knowledge about apathy in first episode patients.
This study found that at baseline, 50% and at follow up 40%, of all patients were considered clinically apathetic. Thirty percent had enduring high levels of apathy over the first year. This group consisted of significantly more males, a longer duration of untreated psychosis, a greater likelihood of a schizophrenia spectrum diagnosis and they had poorer functioning. Apathy correlated only with the neuropsychological tests for executive function and working memory.
This study shows that apathy can be reliably assessed and is a frequent symptom already during the first episode of psychosis and with strong association to poor functioning. As in other brain disorders apathy was associated with poor executive function, implying a possible common underlying mechanism across disorders.
List of papers
1: Assessing apathy: the use of the Apathy Evaluation Scale in first episode psychosis. Faerden A, Nesvåg R, Barrett EA, Agartz I, Finset A, Friis S, Rossberg JI, Melle I. Eur Psychiatry. 2008 Jan;23(1):33-9. Epub 2007 Oct 29. PubMed PMID: 18029152. DOI: 10.1016/j.eurpsy.2007.09.002
2: Apathy and functioning in first episode psychosis. Faerden A, Friis S, Agartz I, Barrett AE, Nesvåg R, Finset A, Melle I Psychiatric Services. (APPI-PS-00468-2008) Accepted for publication June 2009. DOI: 10.1176/appi.ps.60.11.1495http://ps.psychiatryonline.org/cgi/content/full/ps;60/11/1425
3: Apathy is associated with executive functioning in first episode psychosis. Faerden A, Vaskinn A, Finset A, Agartz I, Ann Barrett E, Friis S, Simonsen C, Andreassen OA, Melle I. BMC Psychiatry. 2009 Jan 8;9:1. PubMed PMID: 19133132; PubMed Central PMCID: PMC2640391. DOI: 10.1186/1471-244X-9-1
4: Apathy in first episode psychosis patients: One year follow up Faerden A, Finset A, Friis S, Agartz I, Barrett AE, Nesvåg R, Andreassen OA, Marder SR, Melle I. Submitted Schizophrenia Research 31st of July 2009. Under review.