Review Article

Dysthymia and Apathy: Diagnosis and Treatment

Table 1

Diagnostic criteria for apathy.

Lack of motivation relative to the patient’s previous level of functioning or the standards of his or her age and culture,
as indicated either by subjective account or observation by others.  Presence, with lack of motivation, of at least one
symptom belonging to each of the following three domains.
(i) Diminished goal-directed behavior:
 (a) lack of effort,
 (b) dependency on others to structure activity.
(ii) Diminished goal-directed cognition:
 (a) lack of interest in learning new things or in new experiences,
 (b) lack of concern about one’s personal problems.
(iii) Diminished emotion:
 (a) unchanging affect,
 (b) lack of emotional responsivity to positive or negative events.
The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of
functioning.  The symptoms are not due to a diminished level of consciousness or the direct physiological effects of a
substance (e.g., a drug of abuse, a medication).

Adapted from Starkstein [30].