Adjustment disorder

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

Causes, incidence, and risk factors 

Symptoms of adjustment disorder typically begin within three months of the identifiable stressor and usually do not last longer than six months. Adults often develop adjustment disorder related to marital or financial problems.

In adolescents, common stressors include school problems, family conflict, or sexuality issues. Other stressors for people of any age include the death of a loved one, general life changes, or unexpected catastrophes.

There is no way to predict which people are likely to develop adjustment disorder, given the same stressor. Financial conditions, social support, and career and recreational opportunities can influence how well a person reacts to stress. A given person’s susceptibility to stress may be influenced by such factors as social skills, intelligence, flexibility, genetic factors, and coping strategies.

Symptoms  

To receive a diagnosis of adjustment disorder, symptoms must be severe enough to effect a person’s work or social life. Some of the symptoms that can occur include:

     
  • Depression  
  • Agitation  
  • Trembling or twitching  
  • Palpitations  
  • Conduct disturbances  
  • Physical complaints

Signs and tests 

The following criteria need to be met to establish a diagnosis:

     
  • The person must have a psychological evaluation  
  • The symptoms clearly follow a psychosocial stressor  
  • The symptoms are more severe than would be expected  
  • There do not appear to be other underlying disorders

Treatment  

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.

Expectations (prognosis) 

Adjustment disorders usually resolve quickly without any remaining symptoms.

Calling your health care provider 

Call for an appointment with your health care provider if symptoms suggestive of adjustment disorder develop.

Prevention 

There is no known way to prevent this disorder. Strong support from friends and family can help.

Johns Hopkins patient information

Last revised: December 7, 2012
by Mamikon Bozoyan, M.D.

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