The Lille Apathy Rating Scale (LARS): Exploring its psychometric properties in schizophrenia Hanan Yazbek a,c, ⁎, Joanna Norton c , Delphine Capdevielle b,c , Aurore Larue c , Jean-Philippe Boulenger b,c , Marie-Christine Gély-Nargeot a , Stéphane Raffard a,c a Epsylon EA 4556 Laboratory of Dynamics of Human Abilities & Health Behaviors, University of Montpellier, France b INSERM U-1061, France c University Department of Adult Psychiatry, Hospital La Colombière, CHRU Montpellier, 39 avenue Charles Flahault, 34295 Montpellier Cedex 5, France abstract article info Article history: Received 21 October 2013 Received in revised form 28 March 2014 Accepted 22 April 2014 Available online xxxx Keywords: Apathy Schizophrenia Lille Apathy Rating Scale (LARS) Exploratory factorial analysis Background: Apathy in schizophrenia patients is linked to marked functional impairments and can be defined as a quantitative reduction of voluntary, goal-directed behaviors. If there are now convincing arguments to consider apathy as a multidimensional psychopathological state (cognitive, emotional, and behavioral), there is a lack of validated and standardized instruments for detecting apathy and assessing its multidimensional aspects in schizophrenia. The Lille Apathy Rating Scale (LARS) is a semi-structured interview, yielding a global score and composite subscores for the different domains of apathy and has been validated in several different contexts but not in schizophrenia patients. Objective: The aim of this study is to examine the psychometric properties of the LARS and identify the distinct components of apathy in a sample of schizophrenia patients. Methods: One hundred-and-twelve schizophrenia patients were included and they completed the LARS, The Calgary Depression Scale in Schizophrenia, the Positive and the Negative Syndrome Scale and the Scale for the Assessment of Negative Symptoms. The patient group was compared to 51 healthy control subjects. Results: Principal component analysis showed that the LARS proved a single construct which forms the root of an oblique factor structure reflecting four dimensions: novelty and social life, behavioral involvement, emotional involvement, and judgment skills. The main psychometric properties of the LARS were satisfactory. Conclusions: Our findings show that the LARS has satisfactory psychometric properties when used in a different setting than the original version. The LARS is a promising instrument to examine apathy in schizophrenia through a multidimensional framework. © 2014 Elsevier B.V. All rights reserved. 1. Introduction Apathy is a transnosographic psychopathological state frequently found in different diseases. Indeed, it is estimated at 55% in Alzheimer's disease, 27% in Parkinson's disease, 94% in major depressive episode and 53% in schizophrenia (Mulin et al., 2011). In schizophrenia, there is a lack of positive results in the treatment of apathy, which contributes to poorer functioning and subjective quality of life in both first episode and chronic schizophrenia (Konstantakopoulos et al., 2011; Evensen et al., 2012; Faerden et al., 2013). In literature, there is strong evidence of the multidimensional nature of apathy: behavioral, cognitive and emotional (Marin et al., 1991; Levy and Dubois, 2006; Arnould et al., 2013). Therefore, apathy is defined as a multidimensional psychopath- ological state (cognitive, emotional, and behavioral) manifesting as a reduction of voluntary behaviors directed toward one goal (Levy and Dubois, 2006). Different psychometric tools exist to measure apathy. The most frequently used tools validated in schizophrenia are the Positive and Negative Syndrome Scale (PANSS; Kay et al., 1987), the Scale to Assess- ment of Negative Symptoms (SANS; Andreasen, 1989), the Apathy Evaluation Scale (AES; Marin et al., 1991) and the Brief Negative Symp- tom Scale (BNSS; Kirkpatrick et al., 2011). The SANS, the PANSS and the BNSS each have an “apathy” subscale, but apply different definitions of apathy as a one-dimensional concept. However, apathy requires for its understanding a multidimensional approach. The AES is the most wide- ly used multidimensional tool for assessing apathy in schizophrenia, with good psychometric properties. Nevertheless, limits can be made to this scale. Its semi-structured nature induces a lack of standardization in the administration instructions and scoring method; also the positive and negative orientation of the question may be a possible source of errors. Furthermore, it has not been validated in French and in schizo- phrenia. The multidimensional assessment of apathy, in schizophrenia, is limited. A recent scale, The Lille Apathy Rating Scale (LARS; Sockeel Schizophrenia Research xxx (2014) xxx–xxx ⁎ Corresponding author at: Hôpital de la Colombière, Service Universitaire de Psychiatrie Adulte, CHRU Montpellier, 39 avenue Charles Flahault, 34295 Montpellier Cedex 5, France. Tel.: +33 4 67 33 97 02; fax: +33 4 67 33 89 95. E-mail address: yazbek.hanan@gmail.com (H. Yazbek). SCHRES-05857; No of Pages 7 http://dx.doi.org/10.1016/j.schres.2014.04.034 0920-9964/© 2014 Elsevier B.V. All rights reserved. Contents lists available at ScienceDirect Schizophrenia Research journal homepage: www.elsevier.com/locate/schres Please cite this article as: Yazbek, H., et al., The Lille Apathy Rating Scale (LARS): Exploring its psychometric properties in schizophrenia, Schizophr. Res. (2014), http://dx.doi.org/10.1016/j.schres.2014.04.034