Adjustment disorders

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Tests and diagnosis

By Mayo Clinic staff

Adjustment disorders are diagnosed based on signs and symptoms and a thorough psychological evaluation. To be diagnosed with adjustment disorder, someone must meet criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health professionals to diagnose mental conditions and by insurance companies to reimburse for treatment.

For an adjustment disorder to be diagnosed, several criteria must be met, including:

  • Having emotional or behavioral symptoms within three months of a specific stressor occurring in your life
  • Experiencing distress that is in excess of what would normally be expected in response to the stressor or that causes significant problems in your relationships, at work or at school
  • An improvement of symptoms within six months of the stressful event coming to an end

Types of adjustment disorders
Your health care provider may ask detailed questions about how you feel and how you spend your time. This will help him or her pinpoint which specific type of adjustment disorder you have. There are six main types of adjustment disorders. Although they're all related, each type of adjustment disorder has certain signs and symptoms.

The six types of adjustment disorder are:

  • Adjustment disorder with depressed mood. Symptoms mainly include feeling sad, tearful and hopeless, and a lack of pleasure in the things you used to enjoy.
  • Adjustment disorder with anxiety. Symptoms mainly include nervousness, worry, difficulty concentrating or remembering things, and feeling overwhelmed. Children who have adjustment disorder with anxiety may strongly fear being separated from their parents and loved ones.
  • Adjustment disorder with mixed anxiety and depressed mood. Symptoms include a mix of depression and anxiety.
  • Adjustment disorder with disturbance of conduct. Symptoms mainly involve behavioral problems, such as fighting, reckless driving or ignoring your bills. Youngsters may skip school or vandalize property.
  • Adjustment disorder with mixed disturbance of emotions and conduct. Symptoms include a mix of depression and anxiety as well as behavioral problems.
  • Adjustment disorder unspecified. Symptoms don't fit the other types of adjustment disorders but often include physical problems, problems with family or friends, or work or school problems.
References
  1. Adjustment disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed Feb. 17, 2009.
  2. Strain JJ, et al. Adjustment disorders. In: Hales RE, et al., eds. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Arlington, Va.: American Psychiatric Association; 2008. http://www.psychiatryonline.com. Accessed Feb. 17, 2009.
  3. Adjustment disorders. National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/supportivecare/adjustment/Patient/page4. Accessed Feb. 17, 2009.
  4. Adjustment disorders. In: Sadock BJ, et al. Kaplan and Sadock's Comprehensive Textbook of Psychiatry. 8th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2005. http://www.psychiatryonline.com. Accessed Feb. 17, 2009.
  5. Ahmed SM, et al. Psychosocial influences on health. In: Rakel RE. Rakel: Textbook of Family Medicine. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/1209963843/0/1481/1.html?tocnode=53391787&fromURL=1.html. Accessed Feb. 17, 2009.
  6. Clarkin JF, et al. The role of psychiatric measures in assessment and treatment. In: Hales RE, et al., eds. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Arlington, Va.: American Psychiatric Association; 2008. http://www.psychiatryonline.com. Accessed Feb. 17, 2009.
  7. Bray JH, et al. The family's influence on health. In: Rakel RE. Rakel: Textbook of Family Medicine. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/120920914-7/0/1481/25.html?tocnode=53391850&fromURL=25.html#4-u1.0-B978-1-4160-2467-5..50005-1--cesec2_64. Accessed Feb. 17, 2009.

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March 20, 2009

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