Adjustment Disorder

Question 1

What is an adjustment disorder?

Answer 1

Prolonged severe abnormal response to stress beginning within 1m of stressful episode and lasting no longer than 6

Question 2

What is a prolonged grief reaction?

Answer 2

Abnormal prolonged response to grief. Normal grief onset within a few days and lasts over 2 years, with initial response to anger, guilt, self blame, and later pining, despair and sadness. Abnormal responses include delayed or prolonged response.

Question 3

What is the aetiology and epidemiology of PGR?

Answer 3

Maladaptive psychological processing.

Usually occurs with sudden and unexpected deaths. May have problems in relationships leading to processing difficulties, or being unable to grieve due to putting on brave face.

Question 4

What is in the Hx/Exam of an AD?

Answer 4

Precipitated by stressor. Patient has symptoms of anxiety, depression, irritability, insomnia, low mood. No biological features of depression (i.e. appetite changes). Adjustment to terminal illness may follow a similar course. May have high autonomic arousal.

Question 5

What is in the Hx/ Exam of a PGR?

Answer 5

Hx of difficult relationship, symptoms such as shock, disbelief, anger, sadness and despair may be severe, May feel depressed or have suicidal thoughts.

Question 6

What is the management of an AD?

Answer 6

remove stressor. Supportive psychotherapy, coping mechanisms.

Question 7

What is the management of a PGR?

Answer 7

bereavement counselling, CBT, suicide risk assess.

Question 8

What are the complications prognosis of an AD?

Answer 8

disrupt work and social life, symptoms usually improve rapidly.

Question 9

What are the complications/ prognosis of a PGR?

Answer 9

depression, substance abuse, suicide. Most improve with tx.