Apathy in first episode psychosis patients: One year follow up

Faerden, Ann; Finset, Arnstein; Friis, Svein; Agartz, Ingrid; Barrett, Elizabeth Ann; Nesvåg, Ragnar; Andreassen, Ole A.; Marder, Stephen R.; Melle, Ingrid

doi:10.1016/j.schres.2009.10.014

« Previous Next »Schizophrenia Research
Volume 116, Issue 1 , Pages 20-26, January 2010

Apathy in first episode psychosis patients: One year follow up

Ann Faerden
- Oslo University Hospital, Ullevål, 0407 Oslo, Norway
- Corresponding author. Psychosis Research Section, Division of Psychiatry, Building 49, Oslo University Hospital, Ullevål, 407 Oslo, Norway. Tel.: +47 22118460; fax: +47 23027333.
Arnstein Finset
- Institute of Behavioral Sciences in Medicine, University of Oslo, 0317 Oslo, Norway
Svein Friis
- Oslo University Hospital, Ullevål, 0407 Oslo, Norway
- Institute of Psychiatry, University of Oslo, 0318 Oslo, Norway
Ingrid Agartz
- Institute of Psychiatry, University of Oslo, 0318 Oslo, Norway
- Diakonhjemmet Hospital, 0319 Oslo, Norway
Elizabeth Ann Barrett
- Oslo University Hospital, Aker, 0514 Oslo, Norway
Ragnar Nesvåg
- Diakonhjemmet Hospital, 0319 Oslo, Norway
Ole A. Andreassen
- Oslo University Hospital, Ullevål, 0407 Oslo, Norway
- Institute of Psychiatry, University of Oslo, 0318 Oslo, Norway
Stephen R. Marder
- Department of Psychiatry and Behavioral Sciences, Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
- Departments of Veterans Affairs VISN 22 Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
Ingrid Melle
- Oslo University Hospital, Ullevål, 0407 Oslo, Norway
- Institute of Psychiatry, University of Oslo, 0318 Oslo, Norway

Received 31 July 2009; received in revised form 8 October 2009; accepted 17 October 2009. published online 30 November 2009.

Abstract

Introduction

This study describes how the negative subsyndrome of apathy develops over the first year in first episode psychosis (FEP) patients, with an emphasis on the prevalence of enduring apathy and the relationship between apathy, other symptoms and functioning.

Methods

Eighty four FEP patients were assessed both at baseline and after one year with the abridged clinical version of the Apathy Evaluation Scale (AES-C-Apathy). Other symptoms were assessed with the Positive and Negative syndrome scale (PANSS) and functioning with the split version of the Global Assessment of Functioning Scale (GAF-F).

Results

The mean level of AES-C-Apathy decreased from baseline to the one year follow up for the whole group of FEP patients. High levels of apathy at 1year were best predicted by high levels of apathy at baseline, a long DUP and a diagnosis within the Schizophrenia spectrum. The presence of depression and level of medication only had a minor influence. AES-C-Apathy had a stronger association to GAF-F than other PANSS symptom areas.

Twenty five (30%) FEP patients had high enduring levels of apathy. This group consisted of significantly more males, had a longer duration of untreated psychosis, a greater likelihood of a Schizophrenia spectrum diagnosis, fewer were in remission of positive symptoms and they had significantly poorer functioning at both baseline and follow up.

Conclusion

This study confirms that the negative subsyndrome of apathy is significantly related to poor functioning in FEP. Including negative symptoms and its subsyndromes in early detection strategies are warranted.

Keywords: Psychosis, First episode, Apathy, Negative symptoms, Follow up, Outcome