Research Article Sluggish Cognitive Tempo in a Child and Adolescent Clinical Outpatient Setting Sluggish cognitive tempo (SCT) symptoms have largely emerged from investigations of atten- tion-deficit/hyperactivity disorder (ADHD). Recent research has demonstrated the rele- vance of SCT symptoms in the field of clinical child and adolescent psychiatry. The goal of this research was to study the symptoms of SCT in a clinical child and adolescent sample and to define its features and comorbid conditions. We reviewed 834 clinical records of patients refer- red to Child and Adolescent Mental Health Services and examined SCT symptoms and their relation with sociodemographic data, clinical diagnosis, comorbid conditions, Child Behavior Checklist dimensions, and intelli- gence quotient. Of the 515 patients (age range, 4 to 17 y, 62.5% male) for whom a fully completed Child Behavior Checklist for Children and Adolescents was available, 20.8% showed high levels of SCT symptoms. SCT symptoms were strongly associated with age, internalizing symptoms, learning disabilities, and ADHD inattentive subtype (ADHD-I). No significant correlations with intelligence quotient were found. We concluded that SCT symptoms are highly prevalent in a clinical sample, and that these symptoms might be related to the diffi- culties that some individuals have in respond- ing to demands in their environments, such as academic or social demands, as they increase over time. (Journal of Psychiatric Practice 2016;22;355– 362) KEY WORDS: sluggish cognitive tempo, attention- deficit/hyperactivity disorder, children, adolescents, comorbidity Research on sluggish cognitive tempo (SCT) symp- toms has largely emerged from investigations of attention-deficit/hyperactivity disorder (ADHD), but recent research has demonstrated the relevance of SCT symptoms in the field of clinical child and abnormal psychology. 1,2 At this time, no criteria for a diagnosis of SCT have been officially endorsed, although a large number of investigations have identified the most important behavioral symptoms that characterize SCT. Subjects with SCT symptoms are described as being sluggish/slow to respond and/or to complete a task. They are described as seeming to be “in a fog” with drowsiness/sleepiness, to have trouble staying awake/alert, to be mentally foggy/easily confused, to stare a lot, to display slowness, to appear to be lost in thoughts or daydreaming, with physical hypoactivity/lethargy, to lack initiative or to display effort that fades, not to process questions and explanations accurately, and to appear apathetic and/or withdrawn. 1,3–6 SCT may be a multidimen- sional construct, with several studies identifying at least 2 dimensions that are evident in SCT symptoms, both in Spanish and American pop- ulations. 5,7 These dimensions consist of a cognitive component (ie, inconsistent alertness factor) and a behavioral component (ie, slowness factor). How- ever, other studies have not found SCT to be multidimensional. 3,8 ESTER CAMPRODON-ROSANAS, MS SANTIAGO BATLLE, MS XAVIER ESTRADA-PRAT, MD MARTA ACEÑA-DÍAZ ARAITZ PETRIZAN-ALEMAN, MS ELENA PUJALS, MD LUIS M. MARTIN-LÓPEZ, MD, PhD VÍCTOR PÉREZ-SOLÁ, MD, PhD NÚRIA RIBAS-FITÓ, MD, PhD CAMPRODON-ROSANAS: Institut de Neuropsiquiatria i Addiccions, CSMIJ Sant Martí i La Mina, Parc de Salut Mar, and Departament de Psiquiatria i de Medicina Legal, Universitat Autònoma de Barcelona, Barcelona, Spain; BATLLE, ESTRADA-PRAT, ACEÑA-DÍAZ, PETRIZAN- ALEMAN, PUJALS, and MARTIN-LÓPEZ: Institut de Neuropsiquiatria i Addiccions, CSMIJ Sant Martí i La Mina, Parc de Salut Mar, Barcelona; PÉREZ-SOLÁ: Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona; CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), IMIM (Institut Hospital del Mar d’Investiga- cions Mèdiques); Departament de Psiquiatria i de Medicina Legal, Universitat Autònoma de Barcelona, Barcelona, Spain; RIBAS-FITÓ: CSMIJ Gavà. Fundació Orienta Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. The authors declare no conflicts of interest. Please send correspondence to: Ester Camprodon-Rosanas, MS, C/Ramon Turró, 337-339, 3a planta 08019 Barcelona, Spain. estercamprodon@copc.cat ACKNOWLEDGMENT: The authors gratefully acknowledge Toffa Evans for his accurate grammatical revision. DOI: 10.1097/PRA.0000000000000177 Journal of Psychiatric Practice Vol. 22, No. 5 September 2016 355 Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.