Research Article

Apathy in late-life depression among Taiwanese patients

Shwu-Hua Lee^a1, Ming-Ching Wen^a2, Chia-Chen Chao^a3, Ying Jen Chen^a4 and Cheng-Fang Yen^a5a6 c1

^a1 Department of Psychiatry, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan

^a2 Department of Psychiatry, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan

^a3 Graduate Institute of Clinical Behavioral Science, Chang Gung University, Taiwan

^a4 Department of Internal Medicine, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan

^a5 Department of Psychiatry, College of Medicine, Kaohsiung Medical University, Taiwan

^a6 Department of Psychiatry, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan

ABSTRACT

Background: Apathy is defined as lack of motivation and occurs in a variety of neuropsychological disorders. The Apathy Evaluation Scale (AES) has been shown to be valid and reliable for assessing apathy in depression but the validity and reliability of the Chinese version has never been examined. The aims of the study were to (1) evaluate the validity and reliability of the Chinese version of the AES in late-life depression and (2) evaluate the severity of apathy in late-life depression.

Methods: We translated the AES into Chinese and used a cross-sectional design to evaluate apathy in elderly subjects. Diagnostic and Statistical Manual of Mental Disorders (DSM) -IV criteria and Hamilton Depression Rating Scale (HDRS) were applied for diagnosis and assessment. Three groups of subjects were recruited including one group (n = 31) of patients with major depressive disorder with current depression, the second group (n = 30) with major depressed disorder with remission, and the third group (n = 31) of healthy controls. Convergent validity was tested using four apathy-related items from the HDRS (loss of interest, psychomotor retardation, loss of energy, and loss of insight). Multiple forms of reliability (including internal consistency, test-retest, and interrater) and discriminant validity were examined.

Results: We demonstrated that the internal consistency (coefficient α = 0.90) and test-retest reliability (p < 0.001) were satisfied. Discriminant validity of apathy severity among these three groups was significant. The convergent validity and correlation coefficients based on the four apathy-related items from the HDRS and AES were acceptable.

Conclusion: Apathy is a distinct syndrome which may be treatable when depression is effective managed. Further application of the Chinese version of the AES to study the association of apathy with other neuropsychological symptoms is necessary.

(Received November 30 2006)

(Online publication January 31 2007)

(Revised April 17 2007)

(Accepted April 18 2007)

(Online publication July 26 2007)

Key words

• motivation;
• validity;
• reliability;
• Chinese version;
• apathy-related items

Correspondence:

^c1 Correspondence should be addressed to: Cheng-Fang Yen, Department of Psychiatry, Kaohsiung Medical University Chung-Ho Memorial Hospital, No. 100, Tzyou 1st Rd, Kaohsiung 80756, Taiwan. Phone: 886 7 3121101 ext. 6822; Fax: 886 7 3134761. Email: chfaye@cc.kmu.edu.tw.