Slow cognitive tempo (SCT) is a group of symptoms that affect people with primarily inattentive forms of ADHD-PI, including sleepiness, low energy, daydreaming, and confusion. The cause is thought to be dysregulation of neurotransmitters, resulting in insufficient brain stimulation. SCT is not included in the DSM-IV, causing problems with diagnosis, but may be included in the DSM-V. SCT responds well to ADHD medication, and further research is needed to understand its relationship to depressive disorders and other conditions.
Slow cognitive pace (SCT) refers to a group of symptoms, such as sleepiness, low energy, daydreaming, and confusion, that sometimes affect people with primarily inattentive forms of attention deficit hyperactivity disorder (ADHD-PI). . The cause of SCT is hypothesized to be dysregulation of norepinephrine and other neurotransmitters, resulting in insufficient stimulation of the brain. The topic of SCT has attracted many comments. First, the symptoms are not found in the 2000 Diagnostic and Statistical Manuals-IV® (DSM-IV®), which created problems related to diagnosis. Furthermore, some experts argue that SCT is either a reliable subset of ADHD or an entirely different disorder.
Daydreaming, confusion, poor work output, and sleepiness can keep people from staying focused at work or school. These cognitive slowing symptoms seem to automatically point to ADHD. The missing element of the condition, from a diagnostic point of view, is the high energy or general panache that is almost always present in patients with ADHD. It is unclear why this is missing, and some have argued that SCT is similar to conditions such as major depression or dysthymic disorder, instead of being more similar to ADHD. On the other hand, people with SCT are not necessarily depressed and, like other ADHD patients, suffer from persistent inattention.
Based on the DSM-IV®, it has been very difficult to diagnose ADHD-PI in anyone with slow cognitive tempo characteristics. Many of the symptoms of SCT were listed as diagnostic features of ADHD in DSM-III®, but were removed in DSM-IV®. Using DSM-V® will help solve this problem by including most of these symptoms again. This should make it easier for professionals to see someone with slow cognitive pace as likely to have ADHD. At present, there appears to be no organized intention by a large group of mental health professionals to classify SCT as a different illness, although individual experts have argued for it.
Labeling SCT as just another condition may not be beneficial to anyone. A person with slow cognitive timing characteristics usually responds well to ADHD medications. Methamphetamine is often the most recommended, because methylphenidate may not provide effective treatment for this subgroup. Possibly, serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressants, such as duloxetine and venlafaxine, could also be effective because they interact with norepinephrine levels.
Further scientific research could change the way SCT is viewed in the future. More information about the connection between these symptoms and depressive disorders may be helpful. Another fertile area of study could be the comparison of psychosocial differences of identified ADHD subgroups. Genetic research that pinpoints the causes of SCT and its relationship to other conditions could answer many questions about this cluster of symptoms.
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