Adjustment disorder

Question 1

What is an adjustment disorder?

Answer 1

A severe reaction to a stressful event of life experience

- it’s associated with increased risk of suicide attempts and completions

Question 2

What types of stressors can cause an adjustment disorder?

Answer 2

Single events e.g. break-up, diverse, loss of job or moving to a new place
Recurring stress - seeing family during during holidays
Ongoing stress - financial issues, worsening health
Development changes - becoming a parent, retiring

Question 3

Clinical features of adjustment disorder?

Answer 3

Sadness
Insomnia 
Exhaustion 
Excessive worry
Increased irritability 
Suicidal thoughts 
Decreased self-esteem 
Avoiding social interactions 
Increased or decreased appetite 
Decreased work related performance 
These can all affect relationships, health and/or work performance

Question 4

How is adjustment disorder diagnosed by the ICD-10?

Answer 4

Symptoms occur within one month of specific stressor
Symptoms affect performance of daily, social or occupational functionality
Out-of-proportion of what is a normal response to a stressor
Not a symptom of possible/current mental health disorders
Not due to normal bereavement
Symptoms no more than 6 months after stressor has ended

Question 5

What are the risk factors for developing an adjustment disorder?

Answer 5

Those with high levels of stress

• lower socio-enconomic status
• living in an area with a high crime rate

Question 6

How can adjustment disorders be managed?

Answer 6

CBT - addresses unhelpful thoughts and behaviours
Family therapy - depending on cause of stressor
Group therapy - normalises experiences and shares coping mechanisms
Complete recovery occurs when the stressor ends or the patient adapts to a new situation
Medication
- anti-depressants or anti-anxiety medications for symptom management