Dr A J Mander Consultant Psychiatrist, Next Health

 The presence of a stressor is essential to making the diagnosis  The onset of symptoms must follow the stressor  The diagnosis cannot be made in the presence of another psychiatric diagnosis

 Not well defined  The distinction from normal adaptive reactions is not clear and from other diagnoses like depression and anxiety a matter of debate  Symptoms must be clinically significant although what this means is not defined

 The distinction between adjustment disorder and minor depression mild depression, subclinical depression or subsyndromal depression has not been formulated and it is possible that these terms are used interchangeably

 Consider:  The individuals personal circumstances and the context of the event  The proportionality between the triggering event and the symptom  Cultural and subcultural norms for emotional expression and emotional responses  Severity and duration of resultant functional and social impairment

 Generally considered to be a mild condition with a prognosis significantly better than for other psychiatric conditions (Jones et al 2000) Jones, R., Yates, R.W., Zhou, M.H et al (2002). Readmission rates for adjustment disorders: comparison with other mood disorders. Journal of Affective Disorders 71,

 Alleges assault by deputy principal  Investigation by principal “I am not in a position to recommend or not recommend his claim be upheld”  Seen by Dr S – diagnosis of adjustment disorder in the setting of ‘personal/political issues’ involving the protagonists

 Event and its context  Proportionality of event and symptoms  Cultural norms  Severity and duration of impairment  Continued to work, new girlfriend, holiday in Bali