Adjustment Disorder With Depressed Mood

Adjustment Disorder With Depressed Mood

ADJUSTMENT DISORDER

DEPRESSED MOOD

Adjustment Disorder (Benton & Ifeagwu, 2009, ¶ 2).

The American Psychiatric Association (Schonbeck, 2006, ¶ 2).

DSM-IV: The Diagnostic and Statistical Manual of Mental Disorders (Schonbeck, 2006, ¶ 2).

DSM-IV-TR: Diagnostic and Statistical Manual, Fourth Edition, Text Revision (Benton & Ifeagwu, 2009, ¶ 4).

Not Otherwise Specified (Benton & Ifeagwu, 2009, ¶ 4).

ADJUSTMENT DISORDER WITH DEPRESSED MOOD

"Adjustment disorders are an important and prevalent cause of personal discomfort, absenteeism, addiction, and suicide"

(Fink, 2010, p. 181).

Adjustment disorder (AD) symptoms typically begin during the first few weeks following a significant stressor. In the book, Stress Consequences: Mental, Neuropsychological and Socioeconomic, George Fink (2010), a Neuroendocrinologist and Neuropharmacologist, explains that the individual diagnosed with adjustment disorder must experience symptoms within three months following the commencement of the stressor. An adjustment disorder may be defined as an expansive term for numerous mental states; distinguished by notable behavioral and/or emotional symptoms, Joan Schonbeck, R.N. (2006), Medical Writer Nursing, Massachusetts Department of Mental Health Marlborough, Massachusetts, explains in the journal article, "Adjustment Disorders." For an individual to be diagnosed with having an adjustment disorder, his symptoms must be revealed from a response to a detectable stressor which started within three months of the stressful event. The individual with AD will also experience a decrease in his symptoms within six months of the stressor's removal or when he adapts in a new way to the stressor.

During the paper, which focuses on adjustment disorder with depressed mood, the writer investigates signs of psychopathology of adjustment disorder with depressed mood and differential diagnosis. The writer also discusses pharmacological treatment, education and follow-up as well as nonpharmacological treatment, education and follow-up and appropriate community resources.

Signs of Psychopathology of Adjustment Disorder with Depressed Mood

Either the emotions or behaviors detected with the individual diagnosed with AD, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) should present as extreme or excessive from the associated stressor and have a critical effect on the person's social and educational performance. Fink (2010) asserts that the predominant manifestations of Adjustment Disorder with Depressed Mood include: Depressed mood, "tearful news, and hopelessness. This type must be distinguished from major and depressive disorder and uncomplicated bereavement" (p. 179). The stressor involved may occur from one particular incident that may have occurred in a familiar setting with other individuals present, yet only affects that particular person. In the case where the one affected is a child, the stressor may arise from the child's family, such as divorce or a serious illness of a family member (Schonbeck, 2006).

In most instances, adjustment disorder, normally a "time-limited" illness, generally manifests directly after the display of the stressor and typically dissipates approximately six months after the elimination of the stressor. Schonbeck (2006) explains that the exception to this typical scenario "would be the duration of symptoms related to long-term stressors like chronic illness or even the fall-out from divorce. Though these may appear within three months of the event, resolution may also take longer than six months" (¶ 3). Despite adjustment disorder with depressed mood being accompanied by feelings of sadness or various degrees of hopelessness of varying degrees and generally interfering with the individual's ability to function, the American Psychological Association (APA) does not characterize this or other forms of AD as a mental disorder. AD does, nevertheless, require monitoring and the involvement of a mental health professional as some individuals may experience suicidal ideations.

The journal article, "Adjustment Disorders," by Dr. Tami D. Benton, Director of Clinical Services, Department of Psychiatry, Children's Hospital of Philadelphia and Dr. Judith a Ifeagwu (2009), Research Assistant and Coordinator, Department of Child and Adolescent Psychiatry, Children's Hospital of Philadelphia, explains that due to insufficient behavioral criteria for individuals with AD, validating this disorder proves problematic. AD, a subthreshold disorder, shares characteristics a number of other diagnostic groups as it falls "between defined disorders and problem level (V Code) diagnoses" (Benton & Ifeagwu, ¶ 4). In a number of studies, adjustment disorder with depressed mood depicts the most prevalent subtype of AD assigned. In adult medical settings, general hospitals report 70% of patients with AD experience comorbidity with other psychiatric diagnoses like affective disorders, anxiety disorders, personality disorder, and psychoactive substance abuse disorder.

Differential Diagnosis III

Patricia Casey (2009), University Department of Psychiatry, University Hospital, Dublin, Ireland, explains in the journal article, "Adjustment Disorder," that as one element of the AD diagnosis comprises whether the response to the stressor constitutes a manifestation of appropriate distress, the illness differs from other psychiatric disorders. Casey stresses: "The failure to differentiate appropriate, non-pathological reactions to stressful events from those that are pathological could lead to normal sadness being misdiagnosed as adjustment disorder or depression, simply by the presence of symptoms" (Differential Diagnosis Section, ¶ 1). With the absence of criteria to discern normal from abnormal responses, the clinician's judgment proves critical to characterize the individual's responses as proportionate or excessive. Fink (2010) assets that adjustment disorders must be differentiated from a normal reaction to stress to as well as from other psychiatric disorders that transpire following a stress. According to Fink:

1. In acute stress disorder and posttraumatic stress disorder, the stress needs to be severe and it is more clearly specified. The stressors are psychologically traumatizing of events outside the range of normal human experience so they are expected to produce the same drums in the average human being. Both acute stress disorder and posttraumatic stress are characterized by a specific constellation of affective and autonomic symptoms, which is not encountered in adjustment disorders.