TABLE 2.

Criteria for clinical diagnosis of apathy.

Criterion A: A quantitative reduction of goal-directed activity either in behavioral, cognitive, emotional, or social dimensions in comparison to the patient’s previous level of functioning in these areas. These changes may be reported by the patient themselves or by observation of others.

Criterion B: The presence of at least 2 of the 3 following dimensions for a period of at least 4 weeks and present most of the time.

B1. BEHAVIOR AND COGNITION

Loss of, or diminished, goal-directed behavior or cognitive activity as evidenced by at least one of the following: – reduced level of activity either at home or work, makes less effort or needs to be prompted to perform activities; – less persistence in maintaining an activity or conversation, finding solutions to problems or alternative ways; – less interest in or reaction to news, or less interest in doing new things; – less interest in their own health and well-being or personal image;

B2. EMOTION

Loss of, or diminished, emotion as evidenced by at least one of the following: – less spontaneous (self-generated) emotions regarding their own affairs; – less emotional reaction in response to positive or negative events in the environment, – less concern about the impact of their actions or feelings on the people around him/her; – less empathy to the emotions or feelings of others; – less verbal or physical reactions that reveal his/her emotional states;

B3. SOCIAL INTERACTION

Loss of, or diminished engagement in social interaction as evidenced by at least one of the following: – less initiative in spontaneously proposing social or leisure activities to family or others; – less participation in social or leisure activities suggested by people around them; – less interest in family members; – less likely to initiate a conversation, or early withdrawal from it; – less interest in getting out to meet people;

Criterion C: These symptoms (A–B) cause clinically significant impairment in personal, social, occupational, or other important areas of functioning.

Criterion D: The symptoms (A–B) are not exclusively explained or due to physical disabilities (e.g., blindness and loss of hearing), to motor disabilities, to a diminished level of consciousness, to the direct physiological effects of a substance (e.g., drug of abuse, medication), or to major changes in the patient’s environment.