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Diagnostic Criteria for 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 himself/herself or by observation of others.

Diagnostic Criteria for Apathy

Criterion B1 - BEHAVIOUR & COGNITION

Loss of, or diminished, goal-directed behaviour or cognitive activity as evidenced by at least one of the following.

The patient has a reduced level of activity either at home or work, makes less effort to initiate or accomplish tasks spontaneously, or needs to be prompted to perform them.
He/she is less persistent in maintaining an activity or conversation, finding solutions to problems or thinking of alternative ways to accomplish them if they become difficult.
He/she has less interest or takes longer to make choices when different alternatives exist (e.g., selecting TV programs, preparing meals, choosing from a menu, etc.)
He/she has less interest in or reacts less to news, either good or bad, or has less interest in doing new things.
He/she is less interested in his/her own health and wellbeing or personal image (general appearance, grooming, clothes, etc.)
Check the symptoms if any, then continue.

Diagnostic Criteria for Apathy

Criterion B2 - EMOTION

Loss of, or diminished, emotion as evidenced by at least one of the following.

The patient shows less spontaneous (self-generated) emotions regarding their own affairs, or appears less interested in events that should matter to him/her or to people that he/she knows well.
He/she expresses less emotional reaction in response to positive or negative events in his/her environment that affect him/her or people he/she knows well (e.g., when things go well or bad, responding to jokes, or events on a TV program or a movie, or when disturbed or prompted to do things he/she would prefer not to do).
He/she is less concerned about the impact of his/her actions or feelings on the people around him/her.
He/she shows less empathy to the emotions or feelings of others
(e.g., becoming happy or sad when someone is happy or sad, or being moved when others need help).
He/she shows less verbal or physical reactions that reveal his/her emotional states.
Check the symptoms if any, then continue.

Diagnostic Criteria for Apathy

Criterion B3 - SOCIAL INTERACTION

Loss of, or diminished engagement in social interaction as evidenced by at least one of the following.

The patient takes less initiative in spontaneously proposing social or leisure activities to family or others.
He/she participates less, or is less comfortable or more indifferent to social or leisure activities suggested by people around him/her.
He/she shows less interest in family members (e.g., to know what is happening to them, to meet them or make arrangements to contact them).
He/she is less likely to initiate a conversation, or he/she withdraws soon from it.
He/she prefer to stays at home more frequently or longer than usual and shows less interest in getting out to meet people.
Check the symptoms if any, then continue.

Diagnostic Criteria for Apathy

Criterion C

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

Diagnostic Criteria for Apathy

Criterion D

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