Adjustment disorder

Definition:
A reaction to one or more identifiable stressors that occurs within 3 months of when the stressors started. The reaction is excessive compared to a normal reaction to the stressors, and/or results in impaired functioning.

Causes, incidence, and risk factors:

An adjustment disorder has its onset within 3 months of the identifiable stressor. Symptoms generally do not last longer than 6 months. An adjustment disorder is basically a fairly intense reaction to a life stressor, that is severe enough to disrupt their life but not severe enough to be a major depression or other mood disorder.

The cause is a life stress, but there is no way to predict which people are likely to get an adjustment disorder given the same stressor.

Adults usually develop adjustment disorders related to stressors such as marital discord, finances, work, or school. In adolescents, common stressors include school problems, parental rejection, sexual problems, or parents' marital problems. Other stressors may include death of a loved one, life changes such as retirement or menopause, or unexpected catastrophes. Situational factors that influence how well a person reacts to stress may include economic conditions, availability of social supports, and occupational and recreational opportunities. Intrapersonal susceptibility to stress may include such factors as social skills, intelligence, flexibility, and coping strategies. In children, parental divorce can be a significant stressor.

Symptoms:
Note: Symptoms may vary widely, but duration is usually less than 6 months. The person may or may not be aware of the stressor causing the disturbance.
Signs and tests:

The following criteria need to be met to establish a diagnosis:

  • Psychological evaluation
  • Symptoms are related by time to a psychosocial stressor
  • Symptoms are more severe than would be expected
  • Lack of other underlying disorders (excluding personality disorders or developmental disorders)
Treatment:

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.

When medications are used, they are usually in addition to other forms of treatment.

Expectations (prognosis):

Adjustment disorders are less severe than other disorders. Full recovery is common.

Complications:
Calling your health care provider:

Call for an appointment with your health care provider if symptoms suggestive of adjustment disorder develop.

Prevention:

There is no known way to prevent this disorder. Strong family and social support systems are beneficial.


Review Date: 5/18/2001
Reviewed By: Christos Ballas, M.D., Department of Psychiatry, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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