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Adjustment Disorder

Last updated April 1, 2018

Approved by: Krish Tangella MD, MBA, FCAP

Adjustment Disorder is a psychiatric illness that occurs during times of high stress or mental trauma. Depression is one of the potential complications of Adjustment Disorder.

What are the other Names for this Condition? (Also known as/Synonyms)

  • Exogenous Depression
  • Reactive Depression
  • Situational Depression

What is Adjustment Disorder? (Definition/Background Information)

  • Adjustment Disorder is a psychiatric illness that occurs during times of high stress or mental trauma. It is characterized by abnormal reactions that are stronger than what would be expected for the type of event that occurred
  • The disorder is usually acute, but can occur multiple times in an individual’s life depending on the types of stressors they are exposed to and how they cope with them. Usually social, occupational, and academic abilities are affected
  • The signs and symptoms associated with Adjustment Disorder include impulsive behavior, depression, anxiety, difficulty concentrating, and suicidal thoughts
  • The diagnosis of the condition may involve a complete medical history, a thorough physical and psychiatric exam with mental health assessment
  • The main treatment for Adjustment Disorder is psychotherapy. Generally, there are no long-term complications associated with the disorder. A majority of the individuals get better in about a period of six months

Who gets Adjustment Disorder? (Age and Sex Distribution)

  • Adjustment Disorder can affect males and females of all ages
  • There is no distinct racial or ethnic predilection observed

What are the Risk Factors for Adjustment Disorder? (Predisposing Factors)

Common risk factors of adjustment disorder include:

  • Younger age
  • Stress
  • Serious illness
  • Death of a close friend or family member
  • Financial difficulties
  • Extreme mental trauma
  • Anxiety and depression
  • Bipolar disorder
  • Inadequate treatment to a previous episode of Adjustment Disorder

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Adjustment Disorder? (Etiology)

  • Adjustment Disorder is caused by certain life stressors that an individual may experience and their inability to cope with these stresses
  • Chronic illness, stressful situations, major life changes, sexuality issues, and chemical imbalances in the brain may result in Adjustment Disorder
  • In adults, the common stressors include financial stress, loss of employment, marital conflicts, and personal loss of a close friend or family member
  • The stressors resulting in Adjustment Disorder in a child or teen may include family conflicts such as divorce, bullying in schools, change of schools, sexuality issues, and loss of a close friend or family member

What are the Signs and Symptoms of Adjustment Disorder?

Common signs and symptoms of Adjustment Disorder include:

  • Nervousness
  • Continuous worrying, depression, and anxiety
  • Difficulty concentrating, sleeping
  • Reckless driving
  • Social impairment
  • Avoiding school, inappropriate crime spells
  • Impulsive behavior such as fighting and destroying property
  • Thoughts of suicide

How is Adjustment Disorder Diagnosed?

Adjustment Disorder is classified as an Axis I disorder according to the Diagnostic and Statistical Manual of Mental Disorders (DSM). A diagnosis of the condition may involve:

  • A complete evaluation of medical history and a thorough physical and psychiatric exam
  • The following factors are more associated with Adjustment Disorder diagnosis:

    • Individual’s younger age
    • Psychosocial and environmental issues that have been identified
    • An increased tendency for suicide (which may improve with treatment)
    • A history of psychiatric conditions (in some cases)
    • Shorter treatment duration

Usually, the above strategies are sufficient to make the diagnosis of Adjustment Disorder.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Adjustment Disorder?

There are no long-term complications associated with Adjustment Disorder. Most individuals get better over a period of 6 months with appropriate management of the condition.

Few of the potential complications may include:

  • Depression
  • Risk of suicide or self-injury
  • Alcohol and drug addiction

Adolescents with Adjustment Disorder are more at risk of developing the following psychiatric disorders:

How is Adjustment Disorder Treated?

The main treatment modality for Adjustment Disorder is psychotherapy.

  • Cognitive behavioral therapy: It is a form of psychotherapy (also called  talk therapy) that can help one control and manage their feelings
  • Group therapy: It is another form of psychotherapy in which the support of others can help one feel better
  • Family therapy: Meeting therapy goals along with the family
  • Medications or anti-anxiety drugs may also be prescribed to help cope with Adjustment Disorder

How can Adjustment Disorder be Prevented?

Currently, there is no effective prevention of Adjustment Disorder.

  • The support of a strong family and friend circle can help prevent the onset of the disorder
  • Adequate treatment of an episode of Adjustment Disorder can help prevent recurrences

What is the Prognosis of Adjustment Disorder? (Outcomes/Resolutions)

  • Most cases of Adjustment Disorder are acute, lasting for less than 6 months
  • With appropriate treatment, the stressors can be suppressed with significant improvement in the symptoms; the individuals are also able to resume a normal quality of life

Additional and Relevant Useful Information for Adjustment Disorder:

International Classification of Diseases (ICD) 10 classifies Adjustment Disorders under neurotic, stress-related, and somatoform disorders (under F40-F48).

What are some Useful Resources for Additional Information?

References and Information Sources used for the Article:

Helpful Peer-Reviewed Medical Articles:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Aug. 4, 2015
Last updated: April 1, 2018