Research Information System
38th ECNP, Amsterdam, Netherlands, 11 - 14 October 2025, vol.5, no.1, pp.44, (Full Text)
Abstract Background: Cognitive disengagement syndrome (CDS), formerly
known as sluggish cognitive tempo, is increasingly acknowledged as a distinct
clinical construct. It is characterised by symptoms such as mental fog, day-
dreaming, low initiative, and cognitive slowing, which impair everyday func-
tioning. CDS has shown signi cant associations with internalising
psychopathologies including depression, anxiety, and sleep disturbances [1,2].
While previous research has focused primarily on paediatric populations, the
interactions between CDS, sleep quality, and emotional symptoms in adults
remain underexplored.
Aims: This study aimed to examine the associations between CDS, sleep quality,
and affective symptoms in an adult outpatient sample. In particular, it investi-
gated whether depressive symptoms mediate the relationship between sleep
quality and CDS severity.
Methods: A cross-sectional study was conducted with 220 medication-free adults
aged 18–65 years from a psychiatric outpatient clinic. Participants completed the
Barkley Adult SCT Scale, Pittsburgh Sleep Quality Index (PSQI), Epworth
Sleepiness Scale (ESS), Beck Depression Inventory (BDI), and Beck Anxiety In-
ventory (BAI). Pearson correlations, logistic regression, and mediation analyses
were performed to evaluate direct and indirect relationships between sleep
quality, emotional symptoms, and CDS.
Results: Among participants, 25.9% screened positive for CDS. The CDS+ group
exhibited signi cantly poorer sleep quality, greater daytime sleepiness, and more
Neuroscience Applied 5 (2026) 105737
severe depressive and anxiety symptoms compared to the CDS group (all
p<0.001). Logistic regression revealed that younger age, elevated ESS scores,
and higher BDI scores signi cantly predicted CDS presence, whereas anxiety and
PSQI scores did not. CDS severity was moderately correlated with PSQI and ESS,
and strongly with BDI and BAI scores (all p<0.01). Mediation analysis demon-
strated that depressive symptoms fully mediated the association between PSQI
scores and CDS scores (indirect effect: B¼0.468, t¼4.992, p<0.001), with the
direct effect being non-signi cant.
Conclusions: These ndings indicate that although poor sleep quality is asso-
ciated with CDS, its in uence is primarily indirect and occurs through depressive
symptoms. Addressing depression in individuals experiencing both sleep
disruption and CDS-like cognitive symptoms may be key to effective interven-
tion. The ndings support the use of neuroscience-based nomenclature (such as
CDS) to re ne diagnostic precision and clarify overlapping symptom dimensions
[1,3]. Additionally, the strong association between daytime sleepiness and CDS
underscores the importance of evaluating circadian and behavioural sleep-
related factors in clinical assessment [2,4]. Longitudinal studies are needed to
explore causality and developmental trajectories across age groups [5].