Robert P, Onyike C U, Leentjens A F G, Dujardin K, Aalten P, Starkstein S, Verhey F R J, Yessavage J, Clement J P, Drapier D, Bayle F, Benoit M, Boyer P, Lorca P M, Thibaut F, Gauthier S, Grossberg G, Vellas B, Byrne J
Centre Mémoire de Ressources et de Recherche, CHU de Nice, Nice, France.
Eur Psychiatry. 2009 Mar;24(2):98-104. doi: 10.1016/j.eurpsy.2008.09.001. Epub 2009 Feb 7.
There is wide acknowledgement that apathy is an important behavioural syndrome in Alzheimer's disease and in various neuropsychiatric disorders. In light of recent research and the renewed interest in the correlates and impacts of apathy, and in its treatments, it is important to develop criteria for apathy that will be widely accepted, have clear operational steps, and that will be easily applied in practice and research settings. Meeting these needs is the focus of the task force work reported here. The task force includes members of the Association Française de Psychiatrie Biologique, the European Psychiatric Association, the European Alzheimer's Disease Consortium and experts from Europe, Australia and North America. An advanced draft was discussed at the consensus meeting (during the EPA conference in April 7th 2008) and a final agreement reached concerning operational definitions and hierarchy of the criteria. Apathy is defined as a disorder of motivation that persists over time and should meet the following requirements. Firstly, the core feature of apathy, diminished motivation, must be present for at least four weeks; secondly two of the three dimensions of apathy (reduced goal-directed behaviour, goal-directed cognitive activity, and emotions) must also be present; thirdly there should be identifiable functional impairments attributable to the apathy. Finally, exclusion criteria are specified to exclude symptoms and states that mimic apathy.
人们普遍认为，冷漠是阿尔茨海默病及各种神经精神疾病中的一种重要行为综合征。鉴于近期的研究以及对冷漠的相关因素、影响及其治疗方法重新产生的兴趣，制定一套能被广泛接受、具有明确操作步骤且易于在实践和研究环境中应用的冷漠标准非常重要。满足这些需求是本文所报告的特别工作组工作的重点。该特别工作组包括法国生物精神病学协会、欧洲精神病学协会、欧洲阿尔茨海默病联盟的成员以及来自欧洲、澳大利亚和北美的专家。在共识会议（2008年4月7日欧洲精神病学协会会议期间）上讨论了一份预稿，并就操作定义和标准层级达成了最终协议。冷漠被定义为一种持续存在的动机障碍，应满足以下要求。首先，冷漠的核心特征，即动机减弱，必须至少持续四周；其次，冷漠的三个维度（目标导向行为减少、目标导向认知活动减少和情绪减少）中的两个维度也必须存在；第三，应该有可识别的因冷漠导致的功能损害。最后，明确了排除标准以排除模拟冷漠的症状和状态。
