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Nécessité d'une approche multidimensionnelle de l'apathie dans la schizophrénie : études transversales et longitudinales de l'apathie en lien avec l'anhédonie et le système motivationnel

Abstract : Schizophrenia (SZ) is a chronic psychiatric disease characterized by positive, negative, cognitive, disorganized, emotional and motor symptoms. The lack of positive results in the treatment of negative symptoms led us to be interested in apathy. Apathy is defined as a multidimensional psychopathological state (cognitive, emotional, and behavioral) manifesting as a reduction of voluntary behaviors directed toward one goal. Our aim is to provide a clarification of the concept of apathy by focusing on the relationship between apathy, anhedonia and BIS/BAS. The first study deals with the validation of the Lille Apathy Rating Scale (LARS), which is a multidimensional tool of apathy validated in Parkinson’s disease, in 112 SZ patients. The second study (cross-sectional study) focuses on the link between apathy, consummatory and anticipatory pleasure, social pleasure and BIS/BAS, in 112 SZ patients. Finally, the third study (one year longitudinal study) deals with the evolution of apathy and explores the emotional and behavioral derminants that could predict it. Ours results have shown that the LARS is structured in four factors and has good psychometric properties in SZ. The factor 1 is associated to the BAS and the social and anticipatory anhedonia. The factor 2 is linked to the BIS and the social anhedonia. Thirty-six percent of the patients have an apathy trait. Finally, only anticipatory pleasure predicts the factor 4. Therefore, apathy requires for its understanding a multidimensional approach.Anhedonia and the BIS/BAS cannot by themselves explain the emotional and the behavioral apathy. Consequently, others lines of research need to be explored.
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Hanan Yazbek. Nécessité d'une approche multidimensionnelle de l'apathie dans la schizophrénie : études transversales et longitudinales de l'apathie en lien avec l'anhédonie et le système motivationnel. Psychologie. Université Paul Valéry - Montpellier III, 2013. Français. ⟨NNT : 2013MON30104⟩. ⟨tel-02921460⟩

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