From N. Rasmussen--Article of interest re: Impact of apathy on glycemic control

To My Colleagues,
Attached is the link to a 2008 article published in Diabetes Research and Clinical Practice on the impact of apathy on glycemic control in diabetes. Traditionally, apathy has been viewed as part and parcel of depression. However, more recently in the psychology and psychiatry community, apathy is viewed by many as an independent or at least semi-independent condition separate from clinical depression. The attached study found that over half of the diabetic sample had clinically significant apathy without a diagnosis of depression, and, furthermore, the apathy was correlated with poorer diabetic outcomes compared to the non-apathetic patients regarding HbA1c and self-care.
Two issues seem to be relevant to the family physician regarding the apathy literature and diabetes.  First, virtually all depression tests mingle apathy items with other depressive symptoms and thus it is not always apparent that apathy type symptoms constitute the predominant cluster in a diagnosis of depression.  Second, this has pharmacologic treatment implications – prescribing an SSRI may only exacerbate the apathy when perhaps, based on what I read, a dopamine agent may be more effective. The obvious aim of course would be to decrease the apathy and thereby improve patient self-care and diabetic control. 

HERE is the article