According to the DSM, symptoms (distress and impairment in social and/or occupational settings) must start within three months after exposure to the stressor and must resolve themselves within six months. However, if exposure to the stressor is prolonged then symptoms may exceed six months. 

Diagnosing Adjustment Disorders 

With Adjustment Disorders, there is the expectation of a relatively good outcome, once the responsible stressor is removed. Compared to other mental disorders, Adjustment Disorders are considered to be less severe/disabling than any other disorder when looking at the length of time that the disorder persists, length of hospitalization (if there is hospitalization), and disposition. 

Adjustment Disorder Outcomes

Treating adjustment disorders is very important. Intervention must come rapidly to prevent significant disturbances in the patient's life such as relationship disturbances or trouble functioning in social settings. When treating ADs specifically the aim is to restore the patient's mental health, identify the stressor, work on coping mechanisms, change their perspective on the stressor, and establish relationships to help deal with the stressor. 

Treating Adjustment Disorders 

A stressor is any type of stressful/ significant life change in a person's life that may bring about an Adjustment Disorder in a patient. There are many different types of stressors and the way a person may react to one depends on a variety of factors. 

Adjustment Disorder Stressors

The DSM lists a few subtypes for ADs:
- With depressed mood
- With anxiety
- With mixed anxiety and depressed mood
- With disturbance of conduct 
- With mixed disturbance of emotions and conduct 
- Unspecified

Adjustment Disorder Subtypes

It is commonly thought that suicide risk in those diagnosed with Adjustment Disorders is lower than in those diagnosed with other mental disorders such as Major Depression. The risk for suicide in those with Adjustment disorders is often short-lived and therefore this risk is not looked at as a reason to bar someone from an early discharge if they have indeed been committed to a psychiatric hospital. However, since suicidality or the suicide process rapidly evolves without prior indications of any such thoughts it is essential to assess suicide risk in those with Adjustment Disorders.

Suicide Risk in Those with Adjustment Disorders


Covid-19 exposes an individual to a wide array of stressors such as quarantine, physical distancing, job loss, risk of infection, and loss of a loved one; all of which have the potential to create symptoms of adjustment disorder in that particular individual. 

Adjustment Disorders During Covid-19

This node will contain all references pertaining to adjustment disorders. 

References for Adjustment Disorder Topics

An adjustment disorder (AD) is a reaction to a stressful/significant life change. This reaction is marked by preoccupation with the responsible stressor shown by severe distress (more than what is typically expected) or constant thinking about the consequences of said stressor. This may alter one's mental health as a result. 

New York University

- Anxiety disorders
- Mood disorders 
- Psychotic disorders
- Personality disorders
- Eating disorders
- Sleep disorders
- Addiction
- Adjustment disorders

Categories of mental disorders/mental illnesses

Annett Lotzin, Linda Krause, Elena Acquarini, Dean Ajdukovic, Vittoria Ardino, Filip Arnberg, Maria Böttche, Maria Bragesjö, Małgorzata Dragan, Margarida Figueiredo-Braga, Odeta Gelezelyte, Piotr Grajewski, Xenia Anastassiou-Hadjicharalambous, Jana Darejan Javakhishvili, Evaldas Kazlauskas, Lonneke Lenferink, Chrysanthi Lioupi, Brigitte Lueger-Schuster, Lela Tsiskarishvili, Trudy Mooren, Luisa Sales, Aleksandra Stevanovic, Irina Zrnic, Ingo Schäfer & ADJUST Study Consortium (2021) Risk and protective factors, stressors, and symptoms of adjustment disorder during the COVID-19 pandemic – First results of the ESTSS COVID-19 pan-European ADJUST study, European Journal of Psychotraumatology, 12:1, DOI: 10.1080/20008198.2021.1964197


Risk and protective factors, stressors, and symptoms of adjustment disorder during the COVID-19 pandemic – First results of the ESTSS COVID-19 pan-European ADJUST study

Carta, M.G., Balestrieri, M., Murru, A. et al. Adjustment Disorder: epidemiology, diagnosis and treatment. Clin Pract Epidemiol Ment Health 5, 15 (2009). https://doi.org/10.1186/1745-0179-5-15


Adjustment Disorder: epidemiology, diagnosis and treatment

Disorder Class: Disruptive, Impulse-Control, and Conduct Disorders

A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by the presence of three (or more) of the following criteria in the past 12 months from any of the categories below, with at least one criterion present in the past 6 months:
1. Aggression to people and  animals
2. Destruction of property
3. Deceitfulness or theft
4. Serious violations of rules
 
The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning.
 
If the individual is age 18 years or older, criteria are not met for Antisocial Personality Disorder
 
Specify age onset:  Individuals show at least one symptom characteristic of conduct disorder prior to age 10 years

[DSM-5] Conduct Disorder Criteria

Borderline Personality Disorder (BPD) is primarily defined by a pervasive pattern of instability across interpersonal relationships, self-image, and mood, combined with significant impulsivity. Individuals with this disorder often experience intense emotions and may engage in frantic behaviors to manage their profound fear of abandonment.

Borderline Personality Disorder

A personality disorder is defined by a pervasive and inflexible personality style that significantly deviates from cultural norms, causing problems for the individual and for others. This pattern typically emerges during adolescence or early adulthood and leads to significant distress or functional impairment.

Personality Disorders

Feeding and Eating Disorders are characterized by persistent changes to eating or eating-related behaviors that result in altered consumption or absorption of food, significantly impairing an individual’s physical health and/or psychosocial functioning. 

Feeding and Eating Disorders

Mood disorders are defined as severe disturbances in mood and emotions, which can include depression, mania, and elation. Unlike typical emotional fluctuations, the mood shifts experienced in these disorders are extreme, distort an individual's perspective on life, and significantly impair their ability to function in daily activities.

Mood Disorders

Sleep-Wake Disorders are defined using a multidimensional approach due to the expectations for co-existing or comorbid diagnosis in both mental and neurological health. They are largely characterized by individual’s interpretation of having dissatisfying sleep quality, timing, or amount of sleep. These complaints are often expressed alongside issues of distress or impairment during expected daytime activities. 

Sleep-Wake Disorders

Psychotic disorders are severe mental illnesses characterized by thoughts, perceptions, and behaviors that are so impaired the individual cannot function normally and becomes disconnected from reality. This state of being disconnected from the world is known as psychosis. People with these disorders often lose contact with reality and may experience extreme symptoms like hallucinations and delusions. Schizophrenia is a primary example of a psychotic disorder.

Psychotic Disorders

Adjustment Disorder

Anxiety disorders are characterized by features of excessive fear and anxiety, as well as related behavioral disturbances. These symptoms are often not temporary and linger beyond typical expectations. Excessiveness of these symptoms is clinician diagnosed with cultural contexts taken into consideration.

Anxiety Disorders

- Falls under the umbrella of substance use disorder. The word "addiction" is not formally recognized in the DSM-5.
- Strong, uncontrollable compulsion to administer a drug of abuse to yourself due to dependence.
- Acts on reward circuitry in the brain (dopamine) and changes the chemical composition of your brain over time.
- According to the DSM 5, only gambling addiction has been listed as a diagnosable disorder, the rest of the behavioral addictions are yet to find themselves a place on the DSM manual.

Addiction

Neurodevelopmental disorders (NDDs) are a grouping of disorders that are characterized by onset during the developmental period and present as deficits in functioning. NDDs were first introduced as a category in the DSM-5 in 2013 

NDDs include 
-Intellectual disability (ID) 
-Communication disorders
-Autism Spectrum Disorder (ASD) 
-Attention-Deficit/Hyperactivity Disorder (ADHD)
-Neurodevelopmental Motor Disorders (including tic disorders) 
-Specific Learning Disorders

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