In this naturalistic study, we assessed the effect of sluggish cognitive tempo (SCT) symptoms in the response to methylphenidate (MPH) in 88 children and adolescents with attention-deficit/hyperactivity disorder–Inattentive Type (ADHD-I) according to Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria. SCT symptoms were assessed in these subjects by means of the Child Behavior Checklist (CBCL) scale. The response to MPH after 1 month of treatment was assessed by parental scores in the Swanson, Nolan, and Pelham Questionnaire–Version IV (SNAP-IV) scale. No significant differences were found between subjects with and without SCT symptoms in the response to MPH either assessing presence of SCT symptoms categorically (at least 1 symptom) or dimensionally (p < 0.5 for both analyses; effect size [ES] = 0.24). Our findings corroborate previous phenotypic data suggesting that SCT symptoms do not define a clinically relevant type of ADHD-I.
Get full access to this article
View all access options for this article.
References
1.
AchenbachT. Manual for the Child Behavior Checklist: 4–18 and 1991 Profile. Burlington (Vermont): University of Vermont, Department of Psychiatry, 1991.
2.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 3rd. Washington (DC): American Psychiatric Association, 1980(DSM-III).
3.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th. Washington (DC): American Psychiatric Association, 1994(DSM-IV).
4.
BarkleyRA, DuPaulGJ, McMurrayMB. Comprehensive evaluation of attention deficit disorder with and without hyperactivity as defined by research criteria. J Consult Clin Psychology, 58:775–789. 1990.
5.
Capdevila-BrophyC, Artigas-PallarésJ, Obiols-LlandrichJE. [Sluggish cognitive tempo: Symptoms of predominantly inattentive attention deficit hyperactivity disorder or a new clinical entity?]Rev Neurol, 42(Suppl 2):S127–S134. 2006.
6.
FrickPJ, LaheyBB, ApplegateB, KerdyckL, OllendickT, HyndGW, GarfinkelB, GreenhillL, BiedermanJ, BarkleyR, McBurnettK, NewcornJ, WaldmanI. DSM-IV field trials for the disruptive behavior disorders: Symptom utility estimates. J Am Acad Child Adolesc Psychiatry, 33:529–539. 1994.
7.
HartmanCA, WillcuttEG, RheeSH, PenningtonBF. The relation between sluggish cognitive tempo and DSM-IV ADHD. J Abnorm Child Psychol, 32:491–503. 2004.
8.
JensenPS, MartinD, CantwellDP. Comorbidity in ADHD: Implications for research, practice, and DSM-V. J Am Acad Child Adolesc Psychiatry, 36:1065–1079. 1997.
9.
LaheyBB, CarlsonCL. Validity of DSM-IV attention-deficit/hyperactivity disorder for younger children. J Am Acad Child Adolesc Psychiatry, 37:695–702. 1998.
10.
McBurnettK, PfiffnerLJ, FrickPJ. Symptom properties as a function of ADHD type: An argument for continued study of sluggish cognitive tempo. J Abnorm Child Psychol, 29:207–213. 2001.
11.
PolanczykG, EizirikM, AranovichV, DenardinD, da SilvaTL, da ConceiçãoTV, PiancaTG, RohdeLA. Interrater agreement for the schedule for affective disorders and schizophrenia epidemiological version for school-age children (K-SADS-E)Rev Bras Psiquiatria, 25:87–90. 2003.
12.
PolanczykG, de LimaMS, HortaBL, BiedermanJ, RohdeLA. The worldwide prevalence of ADHD: A systematic review and metaregression analysis. Am J Psychiatry, 164:942–948. 2007a.
13.
PolanczykG, ZeniC, GenroJP, GuimarãesAP, RomanT, HutzMH, RohdeLA. Association of the adrenergic alpha2A receptor gene with methylphenidate improvement of inattentive symptoms in children and adolescents with attention-deficit/hyperactivity disorder. Arch Gen Psychiatry, 64:218–224. 2007b.
14.
ReinhardtMC, BenettiL, VictorMM, GrevetEH, Belmonte-de-AbreuP, FaraoneSV, RohdeLA. Is age-at-onset criterion relevant for the response to methylphenidate in attention-deficit/hyperactivity disorder?J Clin Psychiatry, 68:1109–1116. 2007.
15.
RobinsE, GuzeSB. Establishment of diagnostic validity in psychiatric illness: Its application to schizophrenia. Am J Psychiatry, 126:983–987. 1970.
16.
RohdeLA. Is there a need to reformulate attention deficit hyperactivity disorder criteria in future nosologic classifications?Child Adolesc Psychiatry Clin N Am, 17:405–420. 2008.
17.
RohdeLA, SzobotC, PolanczykG, MartinsS, SchmidtM, TramontinaS. ADHD in a diverse culture: Do research and clinical findings support the notion of a cultural construct for the disorder?Biol Psychiatry, 57:1436–1441. 2005.
18.
SchmitzM, DenardinD, SilvaTL, PiancaT, RomanT, HutzMH, FaraoneSV, RohdeLA. Association between alpha-2a-adrenergic receptor gene and ADHD inattentive type. Biol Psychiatry, 60:1028–1033. 2006a.
19.
SchmitzM, DenardinD, SilvaTL, PiancaT, HutzMH, FaraoneSV, RohdeLA. Smoking during pregnancy and attention-deficit/hyperactivity disorder, predominantly inattentive type: A case-control study. J Am Acad Child Adolesc Psychiatry, 45:1338–1345. 2006b.
20.
SpencerT, BiedermanJ, WilensT, HardingM, O'DonnellD, GriffinS. Pharmacotherapy of attention-deficit hyperactivity disorder across the life cycle. J Am Acad Child Adolesc Psychiatry, 35:409–432. 1996.
21.
SwansonJM, KraemerHC, HinshawSP, ArnoldLE, ConnersCK, AbikoffHB, ClevengerW, DaviesM, ElliottGR, GreenhillLL, HechtmanL, HozaB, JensenPS, MarchJS, NewcornJH, OwensEB, PelhamWE, SchillerE, SevereJB, SimpsonS, VitielloB, WellsK, WigalT, WuM. Clinical relevance of the primary findings of the MTA: Success rates based on severity of ADHD and ODD symptoms at the end of treatment. J Am Acad Child Adolesc Psychiatry, 40:168–179. 2001.
22.
ToddRD, RasmussenER, WoodC, LevyF, HayDA. Should sluggish cognitive tempo symptoms be included in the diagnosis of attention-deficit/hyperactivity disorder?J Am Acad Child Adolesc Psychiatry, 43:588–597. 2004.
23.
WechslerD. WISC-III/Manual. New York: The Psychological Corporation, 1991.
24.
WooBS, ReyJM. The validity of the DSM-IV subtypes of attention-deficit/hyperactivity disorder. Aust N Z J Psychiatry, 39:344–353. 2005.
