Nature of stressors, clinical manifestations and diagnostic concurrence with the new ICD-11 criteria in adjustment disorder: a retrospective data review.

Abstract

Purpose: Adjustment disorder (AD) is a maladaptive reaction to psychosocial stressors, with prevalence reaching up to 50% in certain consultation settings. Research on stressors, clinical profiles, and concurrence with ICD-11 criteria in AD is limited. We aim to assess stressor profiles, clinical manifestations, course, and diagnostic concurrence between ICD-10 and ICD-11 criteria in AD.

Materials and methods: Retrospective review of medical records of adults diagnosed with AD between 2016 and 2020. Stressors were categorized using the Adjustment Disorder New Module 8 (ADNM-8), a validated scale assessing AD symptom severity as per ICD-11 criteria. Data were analysed using PSPP.

Results: Women comprised 57.8% of 445 patients, with a mean age of 32.24 (±9.97) years. The most common stressor was interpersonal relationship (IPR) issues or familial stressors (50.1%). The illness or death of loved ones was a more common stressor among women, while men noted work-related stress more often (p = 0.001). Those under 40 years predominantly faced interpersonal/familial stress (55%), while those over 40 years more frequently experienced illness or death of loved ones (32%; p = 0.001). Depressive symptoms were the most common presentation. Among ICD-11 criteria, preoccupation with and failure to adapt to the stressor were noted in 97.1% and 93.9% patients, respectively. Amongst patients who followed up, 77% showed significant improvement with 36.5% of them having follow up of 2-6 months.

Conclusion: IPR issues were the most common stressors, with gender and age influencing stressor types. AD commonly presented with depressive symptoms, showing high concurrence with ICD-11 criteria and favourable outcomes.