Diagnostic criteria for Adjustment Disorders
( cautionary statement )
A. The development of emotional or behavioral symptoms in response to an identifiable stressor(s) occurring within 3 months of the onset of the stressor(s).
B. These symptoms or behaviors are clinically significant as evidenced by either of the following:
(1) marked distress that is in excess of what would be expected from exposure to the stressor
(2) significant impairment in social or occupational (academic) functioning
C. The stress-related disturbance does not meet the criteria for another specific Axis I disorder and is not merely an exacerbation of a preexisting Axis I or Axis II disorder.
D. The symptoms do not represent Bereavement .
E. Once the stressor (or its consequences) has terminated, the symptoms do not persist for more than an additional 6 months.
Specify if:
Acute: if the disturbance lasts less than 6 months
Chronic: if the disturbance lasts for 6 months or longer Adjustment Disorders are coded based on the subtype, which is selected according to the predominant symptoms.
The specific stressor(s) can be specified on Axis IV.
309.0 With Depressed Mood
309.24 With Anxiety
309.28 With Mixed Anxiety and Depressed Mood
309.3 With Disturbance of Conduct
309.4 With Mixed Disturbance of Emotions and Conduct
309.9 Unspecified
Associated Features:
Depressed Mood
Somatic/Sexual Dysfunction
Guilt/Obsession
Differential Diagnosis: Some disorders display similar or sometimes even the same symptom. The clinician, therefore, in his diagnostic attempt has to differentiate against the following disorders which one needs to be ruled out to establish a precise diagnosis.
Personality Disorders;
Not Otherwise Specified Disorders (e.g., Anxiety Disorder Not Otherwise Specified);
Posttraumatic Stress Disorder, and Acute Stress Disorder;
Psychological Factors Affecting Medical Condition; Bereavement;
Nonpathological Reactions to Stress.
Cause:
Many people have difficulties adjusting to stressful events. Stressful events include starting a new job, ending an important relationship, or conflicts with work colleagues. As a result, the individual may have difficulty with his or her mood and behavior several months after the event. There are as many different responses to stressful events as there are stressful events. Some who have recently experienced a stressor may be more sad or irritable than usual and feeling somewhat hopeless. Others become more nervous and worried. And other individuals combine these two emotional patterns. The symptoms associated with adjustment difficulties usually subside within about 6 months after the stressful event.
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