PREVALENCE, PREDICTORS AND ASSOCIATIONS OF APATHY IN ADULT SURVIVORS OF AN EARLY CHILDHOOD POSTERIOR FOSSA BRAIN TUMOUR
Cliodhna Carroll, Peter Watson, Mike Hawkins, Helen Spoudeas, David Walker, Tony Holland and Howard Ring
Author Affiliation: University of Cambridge
INTRODUCTION: Apathy is a disorder of diminished motivation defined as a deficiency in behavioural, emotional and cognitive components of goal-directed behaviour. It occurs in several neurological pathologies and is associated with pervasive and disadvantageous effects on daily life. In this study we examined prevalence, predictors and associations of apathy in adult survivors of a childhood posterior fossa tumour. METHODS: 118 adult survivors of early childhood (diagnosed before 5 years of age) posterior fossa tumours, and 62 of their siblings, were assessed an average of 32 years after initial tumour treatment, using the Weschler Abbreviated Scale of Intelligence, the Marin apathy evaluation scale and the Composite International Diagnostic Interview.
RESULTS: Apathy scores reached or exceeded clinical cut-off in 35% of survivors compared to 18% of the comparison group. In the survivors this was associated with decreased employment, decreased income and lower self-ratings of physical and mental health. Apathy scores at or above cut-off were associated with lower verbal IQ scores and with a current or previous psychiatric diagnosis, but not with age at tumour treatment (all were < 5 years), duration of follow-up, history of radiotherapy or tumour type (astrocytoma or medulloblastoma). Clinically significant apathy in the survivors was not associated with a diagnosis of depression or with performance IQ measures.
CONCLUSIONS: Clinically significant apathy occurs relatively often in adult survivors of childhood brain tumours and is associated with impaired social functioning and increased psychopathology. Further research should determine whether any tumour or treatment-related variables increase risk of apathy.