Adjustment disorders: the state of the art

Abstract

Adjustment disorders are common, yet under-researched mental disorders. The present classifications fail to provide specific diagnostic criteria and relegate them to sub-syndromal status. They also fail to provide guidance on distinguishing them from normal adaptive reactions to stress or from recognized mental disorders such as depressive episode or post-traumatic stress disorder. These gaps run the risk of pathologizing normal emotional reactions to stressful events on the one hand and on the other of overdiagnosing depressive disorder with the consequent unnecessary prescription of antidepressant treatments. Few of the structured interview schedules used in epidemiological studies incorporate adjustment disorders. They are generally regarded as mild, notwithstanding their prominence as a diagnosis in those dying by suicide and their poor prognosis when diagnosed in adolescents. There are very few intervention studies.

A scoping review of ICD-11 adjustment disorder research

“…Only a few AjD intervention studies were available prior to the ICD-11 proposals (Casey & Bailey, 2011). After the ICD-11 proposals (Maercker et al, 2013), there is still very limited data available on treatment of ICD-11 AjD.…”

Update on adolescent mental health

“…Adjustment disorder in adolescents is associated with an increased risk of suicidal behaviour and, at a later stage, psychiatric disorders. [14] Crisis intervention and brief psychotherapy may be useful options. Pharmacotherapy is generally not indicated, except for short-term relief of insomnia and anxiety symptoms.…”

Untitled

“…A pesar de la gravedad del problema, todavía es considerado una categoría residual en la cual se clasifica a pacientes que no cumplen los criterios diagnósticos para otros trastornos, como ansiedad y depresión, o como diagnóstico temporal cuando los criterios para el trastorno de estrés postraumático o un trastorno del estado de ánimo no están claros (Casey, 2011). Las limitaciones relacionadas con su evaluación y los tratamientos son también relevantes.…”