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Sluggish cognitive tempo is a syndrome related to attention deficit hyperactivity disorder but distinct from it. Typical symptoms include prominent dreaminess, mental fogginess, hypoactivity, sluggishness, staring frequently, inconsistent alertness and a slow working speed.
SCT has been a subject of controversy for decades and debate about its nature still continues. But it is clear now that this set of symptoms is important because it independently has a negative impact on functioning. The SCT symptoms are clinically relevant as they seem linked to a poor treatment response to methylphenidate.
Originally, SCT was thought to occur only in about one in three persons with the inattentive subtype of ADHD, and to be incompatible with hyperactivity. But new studies found it also in some people with the other two ADHD subtypes – and in individuals without ADHD as well. Therefore, some psychologists and psychiatrists view it as a separate mental disorder. Others dismiss it altogether or believe it is a distinct symptom group within ADHD. It even may be useful as an overarching concept that cuts across different psychiatric disorders.
If SCT and ADHD occur together, the problems add up: Those with both had higher levels of impairment and inattention than adults with ADHD only, and were more likely to be unmarried, out of work or on disability. But SCT alone is also present in the population and can be quite impairing in educational and occupational settings, even if it is not as pervasively impairing as ADHD. Some have encouraged the use of the term concentration deficit disorder for SCT because it may be more appropriate and less derogatory.