Definition
-The development of emotional or behavioral symptoms in the presence of psycho-social stressor.
-Symptoms are either :
• Impairment in social , occupational & educational functioning .
• Marked distress that exceeds what is expected from exposure to the stressor.
-Symptoms must occur within 1-3 months of the occurrence of the stressor .
-Symptoms must remit
within 6 months following the cessation of the stressor.
Epidemiology
Male to female ratio is
1:2.
More common in adolescents & hospitalized
medical and surgical patients.
Clinical subtypes
1- Adjustment disorder
with depressed mood : Depression , insomnia
and suicidal ideation.
2- Adjustment disorder
with anxiety:
GAD &increased motor activity.
3- Adjustment disorder
with disturbance of conduct:
Impulsivity, lack of
insight and violent behavior.
4- Adjustment disorder with disturbance of emotion and conduct: Mixture of mood and conduct.!
Treatment
Symptomatic treatment : antidepressants and anxiolytics. Supportive
psychotherapy
Family therapy
A 9-year-old girl is
brought to her pediatrician by her mother because of frequent complaints of
headaches and stomach aches for the past 3 to 4 weeks. The mother tells the
pediatrician that the girl has also been doing worse in school during this same
time period and believes it is a result of the chronic aches. The girl has also
missed many days of school because of her complaints. Mother has already taken
her to have her vision and hearing checked, neither of which is a problem. On
further questioning by the medical student, it is found that the child’s father
is enlisted in the army reserve and left for a 6-month assignment in Iraq 5
weeks ago. He e-mails her almost daily, but the mother notes how much the
daughter worries about him and whether he is safe or not. When interviewed, the
girl also notes that in addition to her worries about her father, she also
sometimes cries frequently and feels better when she talks to her friends. She
occasionally has a bad dream about her father and feels she sleeps more
uneasily as a result.
