Objective: The aims of the present study were to examine the presence of sluggish cognitive tempo (SCT) symptoms in children; associations of the symptoms with sociodemographic characteristics of the children; and relationships between SCT symptoms and symptoms of ADHD, dyslexia, academic performance, and behavioral problems. Method: We evaluated Catalan schoolchildren aged 7 to 10 years in Barcelona, 2012-2013. Parents filled out the SCT–Child Behavior Checklist (SCT-CBCL), the Strengths and Difficulties Questionnaire (SDQ), and a questionnaire concerning sociodemographic characteristics. Teachers completed the ADHD criteria of Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) (ADHD-DSM-IV), a list of dyslexia symptoms, and evaluated the children’s academic performance. SCT symptoms were studied as a continuous and dichotomous variable. Results: In all, 11% of the children in our sample scored above the clinical cut-off on the SCT-CBCL scale. We observed a higher rate of SCT symptoms in boys, children whose father was unemployed, those whose maternal educational level was lower, children with a high socioeconomic vulnerability index at home, those who reported maternal smoking during pregnancy and current second-hand smoke exposure at home, and children with an ADHD diagnosis. More SCT symptoms were associated with inattention symptoms, symptoms of dyslexia, academic problems, and emotional and peer relationship problems. Conclusion: We observed a higher prevalence of SCT symptoms in our sample than expected in the general population. While girls are less prone to SCT symptoms, some socioeconomic indicators, dyslexia, and inattention symptoms as well as exposure to smoking at home increase the risk of SCT and must be taken into account during assessments.

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Our results suggest that SCT symptoms are associated with a neuropsychological profile that is different from the classical ADHD profile and characterized by slower reaction times.

Sluggish cognitive tempo (SCT) symptoms have largely emerged from investigations of attention-deficit/hyperactivity disorder (ADHD). Recent research has demonstrated the relevance 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 referred 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 intelligence 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 difficulties that some individuals have in responding to demands in their environments, such as academic or social demands, as they increase over time.

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Background: Bipolar Disorder (BD) is a recurrent illness associated with high morbidity and mortality. The frequency of mood episode recurrence in BD is highly heterogeneous and significantly impacts the person's psychosocial functioning and well-being. Understanding the factors associated with mood recurrences could inform the prognosis and treatment. The objective of this review is to summarize the literature on factors, present during childhood, that influence recurrence. Methodology:A systematic review of PubMed (1946PubMed ( -2017 and PsycINFO (1884-2017) databases was conducted to identify candidate studies. Search terms included bipolar disorder, episodes, predictors, recurrences, and course. Study characteristics, risk for bias, and factors associated with recurrence were coded by two raters according to predetermined criteria. Results:Twenty child studies and 28 adult studies that retrospectively evaluated childhood variables associated with mood recurrences were included. Early age of onset, low socioeconomic status, comorbid disorders, inter-episode subsyndromal mood symptoms, BD-I/II subtypes, presence of stressors, and family history of BD were associated with higher number of recurrences. Limitations: Risk factors and mood recurrences were assessed and defined in different ways, limiting generalizability. Conclusion: Multiple factors are associated with increased risk of mood episode recurrence in BD. Interventions targeting modifiable factors could reduce the impact of BD. For example, treatment of comorbid disorders and subsyndromal mood symptoms, coupled with appropriate cognitive behavioral and family-focused therapies could ameliorate risk related to many clinical factors. When coupled with social services to address environmental factors, the number of episodes could be reduced and the course of BD significantly improved. K E Y W O R D S bipolar disorder, recurrence, review, risk factors studies only), and race; (i) sample clinical characteristics (number of participants diagnosed with BD, BD I %, illness duration, type of course (eg, predominant polarity, rapid cycling), polarity of the first episode, number of manic, hypomanic, mixed, depressive and total episodes, subsyndromal mood symptoms, comorbid disorders, suicide attempts, and psychotic symptoms); (j) environmental characteristics (living with both natural parents and stressors); (k) family history of BD; (l) assessment tools (eg, how were diagnosis, mood recurrence, and factors measured); (m) outcome or recurrence (definition of recurrence, S U PP O RTI N G I N FO R M ATI O N Additional supporting information may be found online in the Supporting Information section at the end of the article. How to cite this article: Estrada-Prat X, Van Meter AR, Camprodon-Rosanas E, Batlle-Vila S, Goldstein BI, Birmaher B.Childhood factors associated with increased risk for mood episode recurrences in bipolar disorder-A systematic review.

In 2020, quarantine home confinement measures were implemented in Spain to control a pandemic for the first time. The objective of this study is to assess both the psychological and social impact of that ‘lockdown’ on different age groups of children and adolescents and also the different strategies adopted by families in that situation. We collected data via an online questionnaire answered by 850 participants, parents of young people aged between 4 and 18, between 24th April and 8th May 2020. Our results show that living in a home smaller than 80 m2 is associated with an increased risk of presenting clinical symptoms of emotional or behavioural distress, with an odds ratio of 2.54 (95% CI: 1.07–6.02), p = 0.034; while increased age is a predictor of better psychological functioning during lockdown: coefficient of 0.25 (95% CI: 0.07–0.41), p = 0.004. Moreover, age is also a marker of higher scores on the scale of psychological symptoms, with a coefficient of 0.02 (95% CI: 0.01–0.04), p = .005. To conclude, younger children present poorer behavioural and emotional functioning and more symptoms of emotional distress than adolescents during lockdown. Living in a small home is a risk factor for presenting clinical symptoms. These findings should be taken into consideration when planning for future home confinement episodes and when considering preventative strategies in the realm of mental health care.