Detection of Sluggish Cognitive Tempo with d-CPT in children with ADHD

Objective: Considering the clinical presentation of sluggish cognitive tempo (SCT), the continuous performance test (CPT) that reveals the ability to maintain alertness and sustained attention is assumed to be impaired in children with attention deficit hyperactivity disorder (ADHD) accompanied by SCT. This study aimed to evaluate the distracted Continuous Performance Test (d-CPT) for SCT symptoms in children with ADHD. Methods: Among 682 patients aged 7 to 12 years who were evaluated with attention problems between March 2019 and April 2020, a total of 46 patients meeting the inclusion and exclusion criteria were included in the study. The diagnosis of ADHD was made by a specialist child and adolescent psychiatrist using the family and teacher scales. Twenty patients were found to meet at least six items of the Barkley Sluggish Cognitive Tempo Scale–Children and Adolescents (BSCTS-CA), and SCT was accepted to accompany ADHD diagnosis in these children, so they were included in the ADHD+SCT group. Twenty-six patients were included in the ADHD group. The d-CPT tests were administered to both groups. Results: The groups were similar in terms of age, gender, sociodemographic characteristics, and medical history. In the scale data of the ADHD + SCT group, inattention symptoms were found to be significantly higher, to demonstrate significantly poor performance in the “timing” sub-measurement in the d-CPT test battery, and the “timing” sub-measurement was found to significantly differentiate the ADHD + SCT group (AUC: 0.79, sensitivity 85.0%, specificity 66.4%). Conclusion: The present study showed that there might be differences in neurocognitive functions of patients with SCT+ADHD compared to those with ADHD alone. In patients diagnosed with ADHD, SCT diagnosis should also be considered by clinicians, particularly when an impairment is observed in the timing subscale.