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Psychological Medicine
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Harrison Howarth, Jim Bolton, Gary Bell
Adjustment disorder is a state of distress arising in the period of adaptation to a significant life event, such as the diagnosis of a severe physical illness. It occurs in around one-quarter of medical patients.
The needs of migrants in transit
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Olaa Mohamed-Ahmed, Samafilan Ainan, Grazia Caleo, Abdulkarim Ekzayez, Osama Elgamal, Najeeb Rahman, Sakib Rokadiya, Afifah Rahman-Shepherd, Osman Dar
In those who do not meet these criteria, consider ‘adjustment disorder’, especially if the patient has had difficulty in coping with stressful life events. They may have symptoms of depression and a withdrawn attitude. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) defines adjustment disorder as ‘the presence of emotional or behavioural symptoms in response to an identifiable stressor(s) occurring within 3 months of the onset of the stressor(s)’.9
Dysfunctions of COVID-19
Published in Wenguang Xia, Xiaolin Huang, Rehabilitation from COVID-19, 2021
The mental stress events causing adjustment disorder are weak in intensity, and most of them are common events in daily life. The milder condition of adjustment disorder is closely related to personality and individual coping style, and there is a lack of research on the pathological mechanism of this disorder. There is also a lack of epidemiological reports on the incidence rate in adjustment disorder. It has been reported in foreign countries that patients with adjustment disorder account for 5%–20% of psychiatric outpatient clinics.
What are the pharmacotherapeutic options for adjustment disorder?
Published in Expert Opinion on Pharmacotherapy, 2022
AD develops within 1–3 months after a psychosocial stressor and is characterized by distress that is disproportionate to the severity of the stressor. The stressor may be of any severity or type, in contrast to PTSD, which is triggered by exposure to life-threatening traumatic events. However, symptoms of adjustment disorder are characteristic of a trauma- and stressor-related disorder. Thus, it may be accompanied by preoccupations related to the stressor, excessive worrying, rumination, and recurrent or intrusive thoughts related to the stressor and its consequences [1]. DSM-5 lists a number of subtypes of AD, including those with depressed mood, those with anxiety, those with mixed anxiety and depressed mood, those with disturbance of conduct, those with mixed disturbance of emotions and conduct, and those with unspecified. Symptoms of AD are resolved within 6 months unless the stressor or its consequences persist.
The aftershocks of infidelity: a review of infidelity-based attachment trauma
Published in Sexual and Relationship Therapy, 2021
Benjamin Warach, Lawrence Josephs
Other authors suggest employing an adjustment disorder diagnosis for infidelity victimization where applicable, while still acknowledging the trauma that has occurred (Araoz & Carrese, 1996; Lusterman, 2005b). Prototypical examples of adjustment disorder-causing stressors include romantic relationship termination, marital problems, business difficulties or crises, “unfulfilling” sexual relationships, and/or the deaths of loved ones (DSM-5, p. 287). However, the symptom criteria that are currently specified under the DSM-5 adjustment disorder diagnosis and its six subtypes are not specifically responsive to the traumatic symptomatology that characterizes PTSD but only to depression, anxiety, and conduct disturbance. As such, the current diagnostic nosology lacks an accurate label for the acute PTSD-like reactions of certain individuals that suffer romantic betrayal. One possible solution is to create an additional adjustment disorder subtype that is specifically responsive to traumatic reactions from non-life threatening and/or non-sexually violent events. An “adjustment disorder with traumatic symptomatology” diagnosis would better reflect the symptom presentation of infidelity-based attachment trauma that involves acute stress-related PTSD features.
Adjustment disorder after botulinum toxin injection in an adolescent palatal myoclonus case: The importance of informed consent in the treatment of neuropsychiatric disorders in children and adolescents
Published in Alexandria Journal of Medicine, 2018
Yusuf Öztürk, Zehra Topal, Nuran Demir, Ali Evren Tufan
Here we report an adolescent patient who developed adjustment disorder due to adverse effects of botulinum injection to control her palatal myoclonus. Agents including barbiturates, phenytoin, carbamazepine, clonazepam and anticonvulsants/anxiolytics, and sedatives are used in management of palatal myoclonus. Botulinum toxin (BT) treatment is also used. BT acts by preventing release of acetylcholine into the neuromuscular junction and autonomic synapses.3 There have been a few small case series documenting the success and side effects of botulinum toxin injections for treatment of palatal myoclonus. Reported side effects include dysphonia, hypernasality, velopharyngeal insufficiency (VPI) leading to nasopharyngeal regurgitation, dysphagia, and need for repeat injections.4 “Dysphonia” side effect, which our patient perceived as “unexpected and “traumatic”, was experienced by her for the first time in school beside her friends and led to avoidance and psychiatric symptoms and complaints because she was not been adequately informed about pre-treatment effects and adverse effects. So she met adjustment disorder (with depressive mood) criteria for DSM-IV-TR. The exact cause of adjustment disorders have not been determined to date, but likely are a result of the interaction of genetics, exposure to stressors, and altered levels of certain chemicals in the brain. One or more stressful life events, a continuous or recurrent stressor, or a stressor associated with a life stage increases the risk that an adjustment disorder will develop.5