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Adjustment Disorder

Description

Adjustment disorder (AD) is a mental health diagnosis given when one or more challenging and stressful situations (e.g., loss of a job, a move, the death of a loved one, divorce, or other serious loss) cause psychological symptoms that do not meet criteria for more serious disorders.

Although such stressors cause anxiety, depression, grief, or stress in nearly everyone, the symptoms meeting criteria for adjustment disorder may be enduring longer than normally expected. In all true cases of AD, the symptoms are more severe than normal and cause serious impairment to social, occupational, or academic functioning.

A clear (and typically recent) precipitating event – which is not life-threatening - along with a relatively benign symptom picture helps distinguish AD from post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), major depression, chronic depression (dysthymia), bipolar disorder, bereavement, social anxiety, panic disorder, generalized anxiety disorder, and most simple phobias. There are several types of adjustment disorder discussed below, and they differ from each other by their primary mood.

Adjustment Disorders may be classified as acute, which is more typical, or chronic. Chronic AD has a symptom picture that has been ongoing more than six months.

Prevalence

AD is quite common among both adolescents and adults: Available research indicates that as many as 1 in 5 adults seeking mental health services are diagnosed with this problem. Women are twice as likely as men to be classified with this diagnosis.

Risk of Suicide

Despite the relatively benign characteristics of AD, suicidal ideation, plan, and intent are common among its sufferers of all ages. Adolescents, perhaps due to the inherent difficulty of their age group - and their tendency to be impulsive – are especially vulnerable to suicide after experiencing acute stress. That being said, people suffering with AD report suicidal ideation, plan, and behavior much less frequently than those suffering with major depression.

Types of AD

Adjustment disorder is sub-classified into the following: with depressed mood; with anxiety; with anxiety and depression; with conduct disturbance (e.g., vandalism, truancy, fighting, reckless behavior); with depression and conduct disturbance; and with unspecified, primary characteristics. This latter category may be applicable when symptoms include physical complaints, social withdrawal, or inability to work.

Treatment

Counseling, including individual, family, group, and crisis-oriented psychotherapy, is the primary treatment for AD.