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PubMed2000

Apathy.

Deficits in motivated behavior are a very common sequela of most neuropsychiatric disorders, a source of significant disability to the individual, and a source of great frustration to their caregivers. Well-intentioned attempts to encourage certain activities in the apathetic patient often precipitate aggressive, dyscontrolled behavior. The psychopharmacologic approach to motivated behavior deficits is informed by the study of the components, circuitry, and neurochemistry of motivated behavior in animals and humans. This article selectively reviews this literature. The circuitry of motivated behavior involves a combination of behavior specific regions in the hypothalamus as well as a general reward system running from midbrain to forebrain and including important components of several frontal-subcortical circuits. Catecholaminergic systems, particularly the mesolimbic dopaminergic system, are key modulators of motivated behaviors. Treatment thus involves the use of catecholaminergic agents.

Affect↗
PubMed1990

[Apathy syndrome as a sequela of postoperative irradiation of brain tumors in children].

The somnolence syndrome is a postirradiation syndrome in children. It is to be found after cranial irradiation of chemotherapeutically treated children with ALL (acute lymphocytic leukaemia). Rarely, however, it is a radiation sequela of operated cerebral tumors. We report on such a case of somnolence syndrome, review the literature and discuss the diagnostic and therapeutic problems.

Arousal↗
PubMed2001

Depressive symptoms, depletion, or developmental change? Withdrawal, apathy, and lack of vigor in the Geriatric Depression Scale.

PURPOSE OF THE STUDY: Researchers have posited a depletion syndrome among older adults that resembles "depression without sadness." Disengagement-related theories such as socio-emotional selectivity and gerotranscendence also describe an adaptive narrowing of the older person's social world and decreasing investment in activities and social relationships. This study has dual goals of confirming the existence of a "Withdrawal/Apathy/[Lack of] Vigor" (WAV) dimension of the Geriatric Depression Scale (GDS) and exploring its properties for evidence that it may be descriptive of either depletion or disengagement-related change in older adults. DESIGN AND METHODS: Data were obtained through a mailed survey of members 65 and older at a health maintenance organization. Respondents returned 327 completed surveys and 163 "decline" postcards. Principal-components analysis obtained a 6-item WAV factor for further analyses. RESULTS AND IMPLICATIONS: High endorsement rates for the items in WAV and its bivariate correlations with age and health problems suggest WAV may be congruent with disengagement or depletion and may lead to over-identification of depression in older adults. Interpretation of the GDS and similar measures may be improved by use of subscale scores and consideration of age and health status of the respondent.

Adaptation, Psychological↗
PubMed2005

Behaviors associated with dementia: whether resisting care or exhibiting apathy, an older adult with dementia is attempting communication. Nurses and other caregivers must learn to 'hear' this language.

Seemingly simple adjustments in care routines and approaches can make a significant difference in the experiences of people with dementia. This article provides an overview of cognitive impairment in older adults and suggests interventions that can help providers understand the "behavioral symptoms" of dementia, which are often considered a way of communicating unmet needs. By focusing on the person rather than on the disease, nurses promote comfort and functional autonomy in older adults whose cognitive impairments have progressed and yet who are very much alive and deserving of respectful, dignified care.

Aged↗