adjustement disorder (and prolonged grief reactions) Flashcards
ICD 10 definition of adjustment dirosder
states of subjective distress and emotional disturbance, interferencing with social function and perform after SIGNIFANT event (not always death-can be going to uni)
within 1 month of stress event, not lasting over 6m
Aetiology and RF of adjustment dirosder
Maladaptive pscyho response to stress events
any age of onset -technically over 20% of pt could have one
Sx of adjustement disorder
onset within weeks of stressful event - las <6m
anxiety, depression, with NO biological sx of depression,
sx should not be sufficient/severe enough to justify full diagnosis
deemed greater than expected but not as bad as depress/anxiety
What is a normal grief reaction
grief can be normal/abnormal/prolonged
normal -
Shock (days) > anger > guilt> searching > sadness> acceptance
during searching -can have vivid dreams of dead person being alive/pseudo hallucination
What is abnormal/prolonged grief reaction
Delayed onset, greater intensity or prolongation of reaction (longer than 6m), preoccupation with neg thoughts
sucicide ideation, hallucinations
more common if relation with deceased was weird, or sudden death
distinguish from depression -
sadness are focused on person lost (in depression sx are more free floating)
not expect many bio sx of depression
Ix of adjustement disorder and grief reaction
full hx and possible Collateral
MSE
Mx of adjustement disorder and grief reaction
biopschoscial -support, reassurance and problem solving for them often all thats needed
adjustment -
can use antidepressants, anxiolytics/hypnotics
and supporitve councelling
Prolonged/abnormal grief - anti depressants and coucnelling can be used
prognosis -
short term interuption to life
sx resolve after resoluton of cause/time