Athymhormia

Athymhormia (from Ancient Greek θυμός thūmós, "mood" or "affect", and hormḗ, "impulse", "drive" or "appetite"), also called athymhormic syndrome, ( rarely) athymhormia syndrome, psychic akinesia, or auto-activation deficit (AAD) is a rare psychopathological and neurological syndrome characterized by extreme passivity, apathy, blunted affect and a profound generalized loss of self-motivation and conscious thought. It is a disorder of diminished motivation. Symptoms include the loss or reduction of desire and interest toward previous motivations, loss of drive and the desire for satisfaction, curiosity, the loss of tastes and preferences, and flat affect. In athymhormia, however, these phenomena are not accompanied by the characterizing features of depression nor by any notable abnormality in intellectual or cognitive function.^[1][2]

Athymhormia
Specialty	Neurology, Psychiatry
Symptoms	Loss or reduction of desire and interest toward previous motivations, loss of drive and the desire for satisfaction, curiosity, the loss of tastes and preferences, and flat affect.

Origin of diagnostic category

The diagnostic category was coined in 1922 by the French psychiatrists Dide and Guiraud, originally in reference to the behavior identified in some patients with schizophrenia.^[3] Another early description is by French neurologist Dominique Laplane in 1982 as "PAP syndrome" (French: perte d'auto-activation psychique, or "loss of psychic autoactivation"), the syndrome is believed to be due to damage to areas of the basal ganglia or frontal cortex, specifically the striatum and globus pallidus, responsible for motivation and executive functions.^[4] It may occur without any preexisting psychiatric condition.

Symptoms

It is characterized by an absence of voluntary motion without any apparent motor deficit, and patients often describe a complete mental void or blank. This is accompanied by reduced affect or emotional concern (athymhormy) and often by compulsions, repetitive actions, or tics. After stimulation from the outside, such as a direct command, the patient is able to move normally and carry out complex physical and mental tasks for as long as they are prompted to continue.^{[citation needed]}

The symptoms may be differentiated from depression because depression requires the existence of sadness or negative thoughts, while athymhormic patients claim to have complete lack of thoughts, positive or negative.^{[citation needed]}

Cause

The cause of this condition has been hypothesized to derive from abnormalities in the limbic frontal cortex, the striatum, globus pallidus, and dorso-medial thalamic nucleus. In the context of the theory of those who propose the existence of a distinct neural pathway for mood and interest, or the "hormothymic" system, athymhormia may be a disorder of this system.^[5] The existence of athymhormic symptoms in patients after damage to certain structures in the brain has been used in support of a physical model of motivation in human beings, wherein the limbic loop of the basal ganglia is the initiator of directed action and thought.^[3]

See also

• Aboulia

• Akinetic mutism

• Amotivational syndrome
• Anhedonia
• Avolition
• Huntington's disease
• Progressive supranuclear palsy