This two-stage epidemiological study estimated the prevalence of Cognitive Disengagement Syndrome (CDS) without co-occurring ADHD in 366 children in Grades 2–4 from public schools in İzmir, Türkiye, using parent- and teacher-reported screening followed by K-SADS-PL semi-structured and clinical interviews (best-estimate diagnostic procedure).
Screening-stage CDS prevalence ranged from 5.4% to 15.0% depending on informant and impairment criteria. After the best-estimate diagnostic procedure, only 4 children (1.1% of the screened sample) met criteria for CDS without ADHD — representing just 25% of those initially flagged as CDS-only at screening. CDS severity was positively associated with inattention and speech delay, and negatively associated with hyperactivity.
- Small confirmed case count (n=4) limits statistical power and generalizability. - Community sample drawn from a single city (İzmir, Türkiye), restricting cross-cultural applicability. - No population-level denominator reported; the 1.1% figure is relative to the screened subsample, not the full school population.
Single-stage screening for CDS dramatically overestimates its prevalence without ADHD — rigorous multi-stage assessment with structured interviews is essential before diagnosing CDS as a standalone condition. Clinicians should also screen for speech delay and inattention when CDS symptoms are prominent.
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