An adjustment
disorder is a debilitating reaction, usually lasting less than
six months, to a stressful event or situation. The development
of emotional or behavioral symptoms in response to an identifiable
stressor(s) occurring within 3 months of the onset of the stressor(s).
These symptoms
or behaviors are clinically significant as evidenced by either
of the following:
Distress that is in excess of what would be expected from exposure
to the stressor.
Significant impairment in social, occupational or educational
functioning.
The symptoms are not caused by Bereavement.
The stress-related disturbance does not meet the criteria for
another specific disorder. Once the stressor (or its consequences)
has terminated, the symptoms do not persist for more than an
additional 6 months.
Adjustment
Disorders Subtypes:
With Depressed
Mood
With Anxiety
With Mixed Anxiety and Depressed Mood
With Disturbance of Conduct
With Mixed Disturbance of Emotions and Conduct
Unspecified
Associated
Features:
Depressed
Mood
Somatic/Sexual
Dysfunction
Guilt/Obsession
Differential
Diagnosis:
Some disorders display similar or sometimes even the same symptom.
The clinician, therefore, in his diagnostic attempt has to differentiate
against the following disorders which one needs to be ruled
out to establish a precise diagnosis.
Personality
Disorders;
Not Otherwise Specified Disorders (e.g.,
Anxiety Disorder Not Otherwise Specified);
Posttraumatic
Stress Disorder, and Acute
Stress Disorder;
Psychological Factors Affecting Medical Condition; Bereavement;
Nonpathological Reactions to Stress.
Cause:
Many people
have difficulties adjusting to stressful events. Stressful events
include starting a new job, ending an important relationship,
or conflicts with work colleagues. As a result, the individual
may have difficulty with his or her mood and behavior several
months after the event. There are as many different responses
to stressful events as there are stressful events. Some who
have recently experienced a stressor may be more sad or irritable
than usual and feeling somewhat hopeless. Others become more
nervous and worried. And other individuals combine these two
emotional patterns. The symptoms associated with adjustment
difficulties usually subside within about 6 months after the
stressful event.
Treatment:
Counseling and Psychotherapy [ See
Therapy Section ]:
The primary
goals of treatment are to relieve symptoms and assist with achieving
a level of adaptation that is comparable to the affected person's
level of functioning before the stressful event.
Most mental health professionals recommend a form of psychosocial
treatment for this disorder. Treatments include individual psychotherapy,
family therapy, behavior therapy, and self-help groups.
Pharmacotherapy [ See
Psychopharmacology Section ] :
Mental health professionals generally do not use medication
to treat this disorder. When medications are used, they are
usually in addition to other forms of treatment.
Expectations:
Adjustment
disorders are less severe than other disorders. People with
behavior disorders are more likely to later develop antisocial
personality disorder. People with multiple psychiatric disorders
are less likely to return to a previous level of functioning.
Complications:
Major
Depression may develop if help is not obtained.
