Psychiatrists have been trying to figure out what defines Sluggish Cognitive Tempo (SCT). They need to know, among other things, if SCT is just Inattentive ADHD (ADHD-PI) with a coexisting diagnosis of Anxiety and / or Depression and also if SCT is otherwise different from ADHD. They are trying to determine if people who are primarily inattentive need to be removed from the ADHD category all together and be placed in a separate category.

We are a year away from the February 2013 publication date for the DSM V. You may remember that the DSM is the psychiatric manual, written by the American Psychiatric Association (APA) that defines disorders such as ADHD, depression and Sluggish Cognitive Tempo. The manual was last revised in 2000 and a lot has happened since then. One of the topics that we have been following very closely is the issue of how the American Psychiatric Association will label people with Inattentive ADHD and SCT.

It is clear that from an every day, ADHD-PI symptom management, point, that people with ADHD-PI are different from people with combined type and hyperactive type ADHD. The question the APA is battling with is, are they sufficiently sufficient different to warrant a whole new disease category.

Russell Barkley, a respected ADHD expert, believes that SCT is not ADHD with coexisting anxiety and / or depression and according to the study published in the February 2012, Journal of Attention Disorders, he is correct about this. Researchers looked at kids with Inattentive ADHD and found that these kids were more likely to suffer from depression but that SCT symptoms were independently correlated with Inattention. They concluded that SCT was not Inattentive ADHD with anxiety and / or depression.

Barkley has said that most, if not all, of “TRUE” Inattentive ADD patients should be reclassified as having Sluggish Cognitive Tempo because what defines people with this disorder is inattention and slow cognitive processing. He may be correct but this, as of yet, has not been proved.

I believe that people with Inattentive ADHD are more accurately defined as people with fewer impulsive and Emotional control issues and because about 50% of us do have slower cognitive processing, the other 50% of us with ADHD-PI, do not. I think that as more studies are done using functional magnetic resonance (fMRI) we may soon get to the bottom of this. Unfortunately this may not happen in time for the February 2013 publication deadline for the DSM V.