Adjustment Disorder with depressed mood

DSM iv Adjustment Disorder with anxiety

Adjustment disorder is an abnormal and excessive reaction to a life stressor, such as starting school, getting divorced, or grief.

There are six major adjustment disorders:

• Adjustment disorder with depressed mood;
• Adjustment disorder with anxiety;
• Adjustment disorder with mixed anxiety and depressed mood;
• Adjustment disorder with disturbance of conduct;
• Adjustment disorder with mixed disturbance of emotions and conduct;
• Adjustment disorder unspecified.

Diagnostic Criteria of DSM iv Adjustment Disorder

1. The development of emotional or behavioral symptoms in response to an identifiable stressor(s) occurring within 3 months of the onset of the stressor(s).
2. These symptoms or behaviors are clinically significant as evidenced by either of the following:
   1. marked distress that is in excess of what would be expected from exposure to the stressor
   2. significant impairment in social or occupational (academic) functioning
3. The stress-related disturbance does not meet the criteria for another specific Axis I disorder (clinical disorder) and is not merely an exacerbation of a preexisting Axis I or Axis II disorder (Personality Disorder or Mental Retardation).
4. The symptoms do not represent Bereavement.
5. Once the stressor (or its consequences) has terminated, the symptoms do not persist for more than an additional 6 months.

Specify if:

• Acute: if the disturbance lasts less than 6 months
• Chronic: if the disturbance lasts for 6 months or longer

Adjustment Disorders subtypes are selected according to the predominant symptoms:

• With Depressed Mood
• With Anxiety
• With Mixed Anxiety and Depressed Mood
• With Disturbance of Conduct
• With Mixed Disturbance of Emotions and Conduct
• Unspecified

Differential Diagnosis of Adjustment Disorder

Some disorders display similar or sometimes even the same symptom. The clinician, therefore, in his diagnostic attempt has to differentiate against the following disorders which one needs to be ruled out to establish a precise diagnosis.

• Personality Disorders
• Not Otherwise Specified Disorders (e.g., Anxiety Disorder Not Otherwise Specified)
• Posttraumatic Stress Disorder, and Acute Stress Disorder
• Psychological Factors Affecting Medical Condition; Bereavement
• Nonpathological Reactions to Stress.
  

Treatment of Adjustment Disorder

The primary goal of treatment is to relieve symptoms and help the person return to the level of functioning the person had before the stressful event.

Most mental health professionals recommend a form of psychosocial treatment for this disorder. Treatments include individual psychotherapy, family therapy, behavior therapy, and self-help groups.

When medications are used, they are usually in addition to other forms of treatment.

Trauma Disorders

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Site last updated: March 4, 2008

Adjustment Disorder with anxiety