Cincinnati Children's Hospital Medical Center, Ohio, and the University of Cincinnati College of Medicine, Ohio.
University of Colorado Boulder, Boulder, Colorado.
J Am Acad Child Adolesc Psychiatry. 2023 Jun;62(6):629-645. doi: 10.1016/j.jaac.2022.07.821. Epub 2022 Aug 22.
OBJECTIVE: The aim of this work was 2-fold: (1) to evaluate current knowledge and identify key directions in the study of sluggish cognitive tempo (SCT); and (2) to arrive at a consensus change in terminology for the construct that reflects the current science and may be more acceptable to researchers, clinicians, caregivers, and patients. METHOD: An international Work Group was convened that, in early 2021, compiled an online archive of all research studies on SCT and summarized the current state of knowledge, noted methodological issues, and highlighted future directions, and met virtually on 10 occasions in 2021 to discuss these topics and terminology. RESULTS: Major progress has been made over the last decade in advancing our understanding of SCT across the following domains of inquiry: construct measurement and stability; genetic, environmental, pathophysiologic, and neuropsychological correlates; comorbid conditions; functional impairments; and psychosocial and medication interventions. Findings across these domains are summarized, and potential avenues to pursue in the next generation of SCT-related research are proposed. Following repeated discussions on terminology, the Work Group selected "cognitive disengagement syndrome" (CDS) to replace "SCT" as the name for this construct. This term was deemed to best satisfy considerations that should apply when selecting terms for a condition or syndrome, as it does not overlap with established terms for other constructs, is not offensive, and reflects the current state of the science. CONCLUSION: It is evident that CDS (SCT) has reached the threshold of recognition as a distinct syndrome. Much work remains to further clarify its nature (eg, transdiagnostic factor, separate disorder, diagnostic specifier), etiologies, demographic factors, relations to other psychopathologies, and linkages to specific domains of functional impairment. Investigators are needed with interests and expertise spanning basic, clinical, and translational research to advance our understanding and to improve the lives of individuals with this unique syndrome.
目的:本研究旨在双重目的:(1)评估目前关于迟钝认知节奏(SCT)的研究现状,并确定研究重点;(2)对这一概念达成术语变更的共识,反映当前科学现状,提高研究人员、临床医生、护理人员和患者的接受度。
方法:召集了一个国际工作组,该工作组于 2021 年初收集了所有关于 SCT 的研究,并总结了当前的知识状态,指出了方法学问题,并强调了未来的研究方向。2021 年,该工作组还举行了 10 次虚拟会议,讨论这些主题和术语。
结果:在过去十年中,我们在以下研究领域取得了重大进展,加深了对 SCT 的理解:构念测量与稳定性;遗传、环境、病理生理和神经心理学相关性;共病情况;功能障碍;以及社会心理和药物干预。总结了这些领域的发现,并提出了 SCT 相关研究的下一代潜在研究方向。在多次术语讨论之后,工作组选择“认知脱离综合征”(CDS)来取代“迟钝认知节奏”(SCT)作为这一概念的名称。这个术语被认为最能满足选择一个病症或综合征术语时应考虑的因素,因为它与其他概念的既定术语没有重叠,没有冒犯性,并且反映了当前的科学现状。
结论:很明显,CDS(SCT)已经达到了作为一个独特综合征的认知门槛。为了进一步阐明其性质(例如,跨诊断因素、独立障碍、诊断特异性)、病因、人口统计学因素、与其他精神病理学的关系以及与特定功能障碍领域的联系,还有很多工作要做。需要有兴趣和专业知识涵盖基础、临床和转化研究的研究人员来推进我们的理解,改善患有这种独特综合征的个体的生活。
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