Objective To explore the impact of sluggish cognitive tempo (SCT) on the efficacy of atomoxetine in the treatment of attention-deficit/hyperactivity disorder (ADHD).

Methods A prospective study was conducted. Pediatric patients aged 6-12 years with a diagnosis of ADHD were selected from the Department of Psychiatry, Xijing Hospital, Air Force Military Medical University from May 2020 to May 2023. All the patients were treated with atomoxetine for 8 weeks. ADHD symptoms and SCT symptoms were assessed by Swanson, Nolan, and Pelham-Ⅳ rating scale (SNAP-Ⅳ) and SCT rating scale at baseline (before treatment), 4 weeks and 8 weeks after treatment. Pearson correlation analysis was used to analyze the correlation between SCT and SNAP-Ⅳ scores.

Results A total of 61 pediatric patients were enrolled, including 10 cases of inattentive type and 51 cases of mixed type. Baseline SCT score was positively correlated with baseline SNAP-Ⅳ score (r＝0.490, P＜0.001) and reduction rate of SNAP-Ⅳ score at week 8 (r＝0.670, P＜0.001). The total SCT score at week 8 was positively correlated with total SNAP-Ⅳ score at baseline (r＝0.320, P＝0.012). The baseline SCT score of patients with mixed type was positively correlated with reduction rate of SNAP-Ⅳ score at week 8 (r＝0.578, P＜0.001).

Conclusions The severity of SCT symptoms is positively correlated with the SNAP-Ⅳ reduction rate 8 weeks after atomoxetine treatment, which could be a predictor of the efficacy of atomoxetine.