Apathy in first episode psychosis patients: A ten year longitudinal follow-up study

Abstract

BackgroundApathy is a common symptom in first episode psychosis (FEP), and is associated with poor functioning. Prevalence and correlates of apathy 10years after the first psychotic episode remain unexplored. ObjectiveThe aims of the study were twofold: 1) to examine prevalence and predictors of apathy at 10years, and 2) to examine the relationship between apathy at 10years and concurrent symptoms, functioning and outcome, including subjective quality of life. MethodsThree-hundred-and-one patients with FEP were included at baseline, 186 participated in the 10year follow-up. Of these, 178 patients completed the Apathy Evaluation Scale (AES-S-Apathy).Patients were classified as having apathy (AES-S-Apathy≥27) or not. The relationship between apathy and baseline variables (Demographics, Diagnosis, Duration of Untreated Psychosis), measures of symptomatology (Positive and Negative Syndrome Scale, Calgary Depression Scale for Schizophrenia), functioning (Global Assessment of Functioning Scale, Strauss Carpenter Level of Functioning Scale) and subjective quality of life (Lehman's Quality of Life Interview) were estimated through correlation analyses and blockwise multiple hierarchical regression analysis. ResultsNearly 30% of patients met the threshold for being apathetic at follow-up. No baseline variables predicted apathy significantly at 10years. Apathy was found to contribute independently to functioning and subjective quality of life, even when controlling for other significant correlates. ConclusionsApathy is a common symptom in a FEP cohort 10years after illness debut, and its presence relates to impaired functioning and poorer subjective quality of life.