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Psychiatric disorder involving emotional difficulty in response to a stressor

Adjustment disorder is a maladaptive response to a psychosocial stressor. It is classified as a mental disorder. Adult women are diagnosed twice as often as men. Among children and adolescents, girls and boys are equally likely to be diagnosed with an adjustment disorder. Other names for adjustment disorder are stress response syndrome (new name as of 2013) and situational depression since it is one of the most common symptoms.

Some emotional signs of adjustment disorder are: sadness, hopelessness, lack of enjoyment, crying spells, nervousness, anxiety, desperation, feeling overwhelmed and thoughts of suicide, performing poorly in school/work etc. Common characteristics of adjustment disorder include mild depressive symptoms, anxiety symptoms, and traumatic stress symptoms or a combination of the three. According to the DSM 5, there are six types of adjustment disorder, which are characterized by the following predominant symptoms: depressed mood, anxiety, mixed depression and anxiety, disturbance of conduct, mixed disturbance of emotions and conduct, and unspecified. However, the criteria for these symptoms are not specified in greater detail. Adjustment disorder may be acute or chronic, depending on whether it lasts more or less than six months. According to the DSM 5, if the adjustment disorder lasts less than six months, then it may be considered acute. If it lasts more than six months, it may be considered chronic. Moreover, the symptoms cannot last longer than six months after the stressor(s), or its consequences, have terminated. However, the stress related disturbance does not only exist as an exacerbation of a pre existing mental disorder. Unlike major depression, the disorder is caused by an outside stressor and generally resolves once the individual is able to adapt to the situation. The condition is different from anxiety disorder, which lacks the presence of a stressor, or post traumatic stress disorder and acute stress disorder, which usually are associated with a more intense stressor. Suicidal behavior is prominent among people with adjustment disorder of all ages, and up to one fifth of adolescent suicide victims may have an adjustment disorder. Bronish and Hecht (1989) found that 70% of a series of patients with adjustment disorder attempted suicide immediately before their index admission and they remitted faster than a comparison group with major depression. Asnis et al. (1993) found that adjustment disorder patients report persistent ideation or suicide attempts less frequently than those diagnosed with major depression. According to a study on 82 adjustment disorder patients at a clinic, Bolu et al. (2012) found that 22 (26.8%) of these patients were admitted due to suicide attempt, consistent with previous findings. In addition, it was found that 15 of these 22 patients chose suicide methods that involved high chances of being saved. Henriksson et al. (2005) states statistically that the stressors are of one half related to parental issues and one third in peer issues. One hypothesis about adjustment disorder is that it may represent a sub threshold clinical syndrome.

Individuals with an adjustment disorder and depressive or anxiety symptoms may benefit from treatments usually used for depressive or anxiety disorders. The use of different therapies can be beneficial for any age group. There is also a list of medications that can be used to help people with adjustment disorder whose symptoms are too severe for therapy alone. If a person is considering taking medication, they should talk to their doctor. An editorial in the British Journal of Psychiatry described adjustment disorder as being so "vague and all encompassing as to be useless," but it has been retained in the DSM 5 because of the belief that it serves a useful clinical purpose for clinicians seeking a temporary, mild, non stigmatizing label, particularly for patients who need a diagnosis for insurance coverage of therapy. In the US military there has been concern about its diagnosis in active duty military personnel. When the cause of substantial distress is harm caused by unjust social systems, it may be considered that the true disorder requiring intervention lies in the systems causing the problem rather than in the individual who is distressed by them.