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The Second Attention Disorder? Sluggish Cognitive Tempo vs. Attention-Deficit/Hyperactivity Disorder

Update for Clinicians


Journal of Psychiatric Practice®: January 2014 - Volume 20 - Issue 1 - p 38–49
doi: 10.1097/

Sluggish cognitive tempo (SCT) refers to an impairment of attention in hypoactive-appearing individuals that first presents in childhood. At this time, it exists only as a research entity that has yet to debut in official diagnostic taxonomies. However, it seems likely that a constellation of characteristic features of SCT may form the criteria for a newly defined childhood disorder in the foreseeable future, provided limitations in the extant findings can be addressed by future research. Most clinicians who assess and treat cases of attention- deficit/hyperactivity disorder (ADHD) have likely seen and treated someone who falls within the parameters for SCT. This article outlines the history of SCT and reviews the current understanding of the disorder, how it is distinguishable from and similar to other attention disorders, and what future directions research and treatment may take. Based on this review and their clinical experience, the authors conjecture that SCT is probably distinct from ADHD rather than being an ADHD subtype, although there is notable overlap with the ADHD predominantly inattentive and combined presentations. (Journal of Psychiatric Practice 2014; 20:38–49)

SAXBE and BARKLEY: Medical University of South Carolina, Charleston.

Disclosure: Dr. Barkley has been a paid speaker for Eli Lilly and Shire and a paid consultant to Theravance during the previous 12 months and he receives royalties from Guilford Publications for his books, newsletter, rating scales, and videos related to ADHD. One of those rating scales for adult ADHD evaluates SCT. Dr. Saxbe has no relevant disclosures.

Please send correspondence to: Catherine Saxbe, MD, Institute of Psychiatry, 2 North Youth Division, Medical University of South Carolina, 67 President’s Avenue, MSC 861, Charleston, SC 29425-8610.

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