Assessment of motivation in schizophrenia: Patient- and clinician-rated outcomes
Year: 2025
Type: article
Study design: Observational Study
Abstract: INTRODUCTION: Negative symptoms, such as apathy and diminished motivation, are critical for prognosis and treatment outcomes in neurological and psychiatric disorders. However, constructs and assessment scales differ significantly across neuropsychiatric disorders. This study examines the psychometric properties of two scales used to assess apathy - the apathy-motivation index (AMI) and the diagnostic criteria for apathy (DCA) - compared to schizophrenia-specific tools, namely the brief negative symptoms scale (BNSS) and the positive and negative syndrome scale (PANSS). METHODS: We conducted a cross-sectional, multicenter study with 151 individuals with schizophrenia across six European sites. Participants were assessed using the AMI, DCA, BNSS, PANSS, and other clinical and functional scales. BNSS motivation and pleasure factor (BNSS_MAP) assessed motivation, and personal and social performance (PSP) assessed functioning. Convergent validity across these tools was examined through bivariate correlations (Pearson r) and exploratory factor analysis for the AMI. Cut-off points for apathy used receiver operating characteristic (ROC) analysis, with DCA as the reference. RESULTS: We found low convergence between BNSS_MAP and AMI (r=.31, p<.001) and moderate convergence between BNSS_MAP and DCA (r=.48, p<.001). PSP correlated with BNSS_MAP, PANSS_negative and DCA (r=-.615, r=-.446 and r=-.430, respectively, all p<0.001), but not with AMI (r=-.108; p=.218). ROC analysis yielded cut-off points of 28.5 (BNSS total), 16.5 (BNSS_MAP), 14.5 (PANSS_negative), and 33.5 (AMI total) for detecting clinical apathy. CONCLUSION: Current apathy and motivation scales show limited overlap, reflecting the complexity of measuring transdiagnostic constructs. Combining clinician- and patient-rated measures may provide a more comprehensive understanding of apathy in schizophrenia and other neuropsychiatric conditions.
Authors: Emilio Fernandez-Egea, Gabriel Robert, Anna Mane, Michel Sabé, Noemie Kuenzi, Mariia Kaliuzhna, Fabien Carruzzo, Fiona Diniel, Anne Julie Riclet, Laura Martinez-Sadurni, Elif Ates Budak, Bruno Giordana, Paola Bucci, Giula Maria Giordano, Luigi Giuliani, Peter B. Jones, Dominque Drapier, Silvana Galderisi, Philippe Robert, Stefan Kaiser, Noham Wolpe, Armida Mucci
Institutions: University of Cambridge, Cambridgeshire and Peterborough NHS Foundation Trust, Institut national de recherche en sciences et technologies du numérique, Institut de Recherche en Informatique et Systèmes Aléatoires, CIC Rennes, Centre Hospitalier Guillaume Régnier, Centre Hospitalier Universitaire de Rennes, Empenn, Centro de Investigación Biomédica en Red de Salud Mental, Centro de Investigación Biomédica en Red, Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, University of Geneva, University Hospital of Geneva, Hospital Del Mar, Dicle University, Dicle Üniversitesi Hastaneleri, Université Côte d'Azur, University of Campania "Luigi Vanvitelli", Tel Aviv University
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $1,910
Funders: National Science Foundation, United States - Israel Binational Science Foundation, Teva Pharmaceutical Industries, Fondation de l'Avenir pour la Recherche Médicale Appliquée, Wellcome Trust, Les Laboratories Pierre Fabre, National Institute for Health and Care Research, Department of Health and Social Care, Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung, Gedeon Richter, Israel Science Foundation, H. Lundbeck A/S, Neuraxpharm, National Institutes of Health, Medical Research Council, Programme Grants for Applied Research, NIHR Cambridge Biomedical Research Centre, Cilag
Awards: G1107003472, Infektionen bei Immunsuppression., G139696651, Untersuchungen über die Mechanismen, die eine Ein- wanderung von Thymocyten-Vorläufern in Thymus und von reifen T-Zellen an den Ort der Abstossung be-, G2158439337, G370598735, Neural and behavioral markers for the motivational negative symptoms of schizophrenia - a longitudinal approach, G4630004693, Defining, understanding, and treating lack of motivation in schizophrenia, G6641991021, G7530906953, G8002845744, G8094537141, G956441251
OpenAlex ID: W4416399459