Adjustment disorder is a psychological response to an identifiable stressor or stressors, characterized by emotional distress and functional impairment that exceed what would be expected given the nature of the stressor

Aetiology

• The development of adjustment disorder is multifactorial and can occur in the context of any significant life change or stressful event such as death of a loved one, divorce or separation, job loss, major life changes, or significant personal events
• However, individual responses to similar stressors can vary significantly, suggesting that personal susceptibility and coping mechanisms play a significant role in the disorder's manifestation

Clinical features

In adjustment disorder, post-traumatic stress disorder (PTSD) features should:

1. Last for at least one month but not longer than six months after the stressor
2. Include a delayed and/or prolonged response to a stressful event or situation that is threatening or of a catastrophic nature and is likely to cause distress in anyone
3. Present episodes of repeated reliving of the trauma (flashbacks) in memories or dreams
4. Lead to a sense of 'numbness' and detachment from other people
5. Result in avoidance of activities and situations reminiscent of trauma
6. Be accompanied by autonomic hyperarousal symptoms such as hypervigilance, an enhanced startle reaction, insomnia, and poor concentration

Investigations

• ICD-11 diagnosis

Management

• Psychotherapy - CBT, group therapy, family therapy
• Medication (anti-anxiety, antidepressants) may be helpful in some cases
• Self-care strategies - stress management, regular physical activity, maintaining strong social support networks
• Symptoms typically improve once the individual is able to cope with the stressor or the stressor is removed