Multidimensional apathy: A simple and inclusive clinical marker of youth mental health—A longitudinal study
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Background
Early identification and treatment of young individuals at risk for psychiatric disorders are essential to reducing the burden of mental health disorders, which are among the leading causes of disability worldwide. This study aims to determine whether different phenotypes of multidimensional apathy could be potential predictors to the transition to distinct psychiatric disorders in youth and whether they may serve as clinical markers.
Methods
In a longitudinal study, we followed 470 young adults over a period of 4.5 years. They completed online surveys, providing self-reported diagnoses of psychiatric disorders along with socio-demographic, medical, educational, and functional characteristics. Multidimensional apathy, self-esteem, depressive symptoms, and motivation were assessed using validated scales. Binary logistic regression analyses were conducted to identify predictors of psychotic or depressive disorders at the 4.5-year follow-up, while a Chi-squared test examined the stability of multidimensional apathy over time.
Results
The presence of a self-diagnosed psychotic disorder in 2024 was predicted in 2020 by a low self-esteem (β=−0.19;p<3.9×10−8), consumption of legal psychoactive drugs (β=1.13;p<0.002), an absence of anxiety (β=−2.22;p<0.003), higher emotional apathy (β=1.83;p<0.006), lack of leisure (β=−1.774;p<0.02), antecedents of psychiatric disorders in first-degree relatives (β=1.505;p<0.03), and consumption of illicit substances other than cannabis (β=1.726;p<0.03), with an overall accuracy of 76.81%. The presence of a depressive disorder was predicted by subclinical depressive symptoms (β=5.672;p<2.3×10−6), being a junior in university (β=3.681;p<0.003), presence of non-psychiatric disorders (β=1.899;p<0.03), higher executive apathy (β=2.229;p<0.03), consumption of alcohol (β=2.128;p<0.06), and lack of independence (β=−1.867;p<0.07), with an overall accuracy of 91.47%. Participants presented a temporal stability for emotional and executive apathy between 2020 and 2024 (p<2.2×10−16).
Conclusions
Our results show for the time emotional and executive apathy as predictors of the transition to psychosis and depression, respectively, at 4.5 years, suggesting multidimensional apathy as an easy-to-implement and inclusive candidate for clinical markers of youth mental health.
