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Abstract Background Apathy is a very common behavioural and psychological symptom across brain disorders. In the last decade, there have been considerable advances in research on apathy and motivation. It is thus important to revise the apathy diagnostic criteria published in 2009. The main objectives were to: a) revise the definition of apathy; b) update the list of apathy dimensions; c) operationalise the diagnostic criteria; and d) suggest appropriate assessment tools including new technologies. Methods The expert panel (N = 23) included researchers and health care professionals working on brain disorders and apathy, a representative of a regulatory body, and a representative of the pharmaceutical industry. The revised diagnostic criteria for apathy were developed in a two-step process. First, following the standard Delphi methodology, the experts were asked to answer questions via web-survey in two rounds. Second, all the collected information was discussed on the occasion of the 26th European Congress of Psychiatry held in Nice (France). Results Apathy was defined as a quantitative reduction of goal-directed activity in comparison to the patient's previous level of functioning (criterion A). Symptoms must persist for at least four weeks, and affect at least two of the three apathy dimensions (behaviour/cognition; emotion; social interaction; criterion B). Apathy should cause identifiable functional impairments (criterion C), and should not be fully explained by other factors, such as effects of a substance or major changes in the patient's environment (Criterion D). Conclusions The new diagnostic criteria for apathy provide a clinical and scientific framework to increase the validity of apathy as a clinical construct. This should also help to pave the path for apathy in brain disorders to be an interventional target. [ABSTRACT FROM AUTHOR]

Introduction: Psychotic disorders such as schizophrenia and bipolar disorder are complex neuropsychiatric conditions of multifactorial etiology whose diagnosis is currently based solely on clinical interview methodology. Therefore, biomarkers which could improve the current classification and in perspective stratify patients on a biological basis into more homogeneous clinically distinct subgroups, are highly needed. Objectives: We describe here the preliminary data on the application of a protein profiling investigation for the identification of peripheral markers for psychotic disorders, based on a proteomic approach. Aims: To identify serum protein biomarkers in patients with acute phase psychotic disorder compared with anxiety or depressive disorders with no history of psychosis. Methods: Patients were sampled and evaluated by means of SCID-I, PANSS, YMRS, HAM-A, HAM-D. Lymphocytes have been separeted and Two-Dimensional Electrophoresis (2-DE) was carried out on protein extracts. Analysis was performed using Progenesis Same Spot software. Result: 2-DE showed significant differences in protein patterns between the two groups, in particular some protein spots are upregulated in a statistically significant manner and are under identification by mass spectrometry. PCA underlies a clear separation between the two groups, with a t1 value for the first component of 54%. Conclusions: Preliminary analysis of a small sample shows significant differences in protein pattern between acute psychotic patients compared with non-psychotic psychiatric controls. Further work will widen the sample and will identify the single proteins. [ABSTRACT FROM AUTHOR]