Adjustment Disorders

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 Stress reaction to stress adaptation to stress

Adjustment Disorders
ICD-10 1 6 DSM-IV / 3 6
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Within three months of the stressor, there is marked distress that is in excess of what one would expect and Does not meet the criteria of another Axis I disorder, more specifically does not meet the criteria of PTSD or Bereavement. Does not last longer than 6 months unless the stressor so lasts.
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 Stress 1-3 month symptom ------> 6 month ------> Function

Etiology
Vulnerable person genetic defense mechanism Overloaded stress Support system
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Symptoms of Adjustment disorder Anxious mood depressed mood conduct behavior suicide
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With depressed mood With anxiety With Mixed anxiety and depressed mood With Disturbance of conduct With Mixed disturbance of emotions and conduct Unspecified
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Acute v. chronic
6 months. Six months can only fit the definition of adjustment disorder if the stress last longer than 6 months. So, could use chronic for pt living in very fearful neighborhood.

Prevalence

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Differential Diagnosis
mood disorder / anxiety disorder antisocial personality PTSD coexisting Dx

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course
1. Progress to severe pathology alcohol/substance abuse major depression bipolar disorder dysthymic disorder psychotic disorder

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Course
2. Disappeared 3. Off and on

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Defensive style
Mature defense suppression sublimation altruism immature defense projection introjection somatization
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END

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