Adjustment Disorder: A Review of Clinical Presentation, Pathophysiology, and Treatment
Abstract
Adjustment disorder is a common and often neglected mental health disorder that is classified in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). This review article provides an overview of the clinical presentation, pathophysiology, and treatment of adjustment disorder. Clinical presentation of adjustment disorder includes a range of symptoms, including affective, behavioral, and cognitive symptoms. The pathophysiology of adjustment disorder is largely unknown, although genetic, environmental, and psychosocial factors have been identified as potential contributors. Treatment approaches for adjustment disorder typically involve cognitive-behavioral therapy, medications, psychotherapy, and/or supportive psychosocial interventions.
Keywords: Adjustment disorder; DSM-5; Clinical presentation; Pathophysiology; Treatment
Introduction
Adjustment disorder is a common yet often neglected mental health disorder, which is characterized by the development of clinically significant emotional and behavioral symptoms in response to an identifiable psychosocial stressor (American Psychiatric Association, 2013). Adjustment disorder is classified as a DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition) diagnosis, which is characterized by the development of clinically significant emotional and behavioral symptoms in response to an identifiable psychosocial stressor (American Psychiatric Association, 2013). It is estimated that up to 10% of the general population will meet diagnostic criteria for adjustment disorder at some point in their life (Keller et al., 2000). This review article will provide an overview of the clinical presentation, pathophysiology, and treatment of adjustment disorder.
Clinical Presentation
The clinical presentation of adjustment disorder is heterogeneous and can vary greatly from person to person. Affective symptoms commonly present in individuals with adjustment disorder include depressed mood, feelings of sadness and hopelessness, and anxiety (American Psychiatric Association, 2013). Behavioral symptoms may include social withdrawal, irritability, and difficulty concentrating (American Psychiatric Association, 2013). Cognitive symptoms may include negative self-beliefs, poor concentration, and difficulty making decisions (American Psychiatric Association, 2013).
Pathophysiology
The pathophysiology of adjustment disorder is largely unknown, although genetic, environmental, and psychosocial factors have all been identified as potential contributors (Keller et al., 2000). Previous research has shown that individuals with a family history of mental illness are more likely to be diagnosed with adjustment disorder (Keller et al., 2000). Additionally, individuals who have experienced significant life stressors, such as death of a loved one, divorce, or loss of a job, are more likely to develop adjustment disorder (Keller et al., 2000).
Treatment
The treatment of adjustment disorder typically involves a combination of cognitive-behavioral therapy, medications, psychotherapy, and/or supportive psychosocial interventions (American Psychiatric Association, 2013). Cognitive-behavioral therapy is a type of psychotherapy that focuses on helping individuals identify and modify their maladaptive thoughts and behaviors (American Psychiatric Association, 2013). Medications that have been used to treat adjustment disorder include selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, and benzodiazepines (American Psychiatric Association, 2013). Psychotherapy is used to help individuals identify and address underlying issues that may be contributing to their adjustment disorder (American Psychiatric Association, 2013). Finally, supportive psychosocial interventions may include support groups, family counseling, and lifestyle modifications (American Psychiatric Association, 2013).
Conclusion
Adjustment disorder is a common yet often neglected mental health disorder that is characterized by the development of clinically significant emotional and behavioral symptoms in response to an identifiable psychosocial stressor. The clinical presentation of adjustment disorder is heterogeneous and can vary greatly from person to person. The pathophysiology of adjustment disorder is largely unknown, although genetic, environmental, and psychosocial factors have been identified as potential contributors. Treatment approaches for adjustment disorder typically involve cognitive-behavioral therapy, medications, psychotherapy, and/or supportive psychosocial interventions.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association.
Keller, M. B., Lavori, P. W., Mueller, T. I., Endicott, J., Coryell, W., & Hirschfeld, R. M. (2000). Time to recovery, chronicity, and levels of psychopathology in major depression and bipolar disorder. Archives of General Psychiatry, 57(5), 415-420. doi: 10.1001/archpsyc.57.5.415