Vascular risk factors for depression and apathy | Part II 132 Table 2. Overlapping and distinguishing symptoms between apathy and depression Apathy diagnostic criteria (2018) Depression diagnostic criteria (DSM-5) (A) A quantitative reduction of goal-directed activity (behavioural, cognitive, emotional or social) in comparison to the patient’s previous level of functioning. (B) Symptoms of at least 2 of the 3 following dimensions for at least 4 weeks. (C)These symptoms cause clinically significant impairment in functioning. (D) The symptoms are not solely attributable to physical or motor disabilities, a diminished level of consciousness, substance use or major changes in the patient’s environment. (A)The individual must be experiencing five or more symptoms during the same 2-week period and at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure (core criteria). (B) Collectively, these symptoms must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. (C)These symptoms must not be caused by a somatic condition or use of medication or drugs. (D)These symptoms must not be caused by another psychiatric disorder. (E) No manic or hypomanic episodes Overlapping symptoms B1 BEHAVIOUR AND COGNITION: reduced general level of activity; diminished persistence of activity; less interest or slow in making choices; less interest in external issues; less interest in own health and image. 2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day. 5. A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down). 8. Diminished ability to think or concentrate, or indecisiveness, nearly every day. B2 EMOTION: less spontaneous emotion; fewer emotional reactions to the environment; less concern about the impact of actions/feelings on others; less empathy; less use of verbal or physical expressions 2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day. B3 SOCIAL INTERACTION: less spontaneous social initiative; less environmentally stimulated social interaction; decreased interest in interactions with family members; less verbal interaction; being more homebound 5. A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down). Distinguishing symptoms 1. Depressed mood most of the day, nearly every day. 3. Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day. 4. Insomnia or hypersomnia nearly every day. 6. Fatigue or loss of energy nearly every day. 7. Feelings of worthlessness or excessive or inappropriate guilt nearly every day. 9. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
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