Adjustment Disorder

ADJUSTMENT DISORDER

Q. 1

Miss B, a 27 year old nurse had extracurricular interest in trekking and painting. She broke up relationship with her boy friend. Two months later she lost interest in her hobbies and was convinced that she would not be able to work again. She thought life was not worth living and has consumed 60 tablets of phenobarbitone to end her life. She is most likely suffering from:

 A

Adjustment disorder

 B

Conversion disorder

 C

Depressive disorder

 D

Post-traumatic stress disorder (PTSD)

Q. 1

Miss B, a 27 year old nurse had extracurricular interest in trekking and painting. She broke up relationship with her boy friend. Two months later she lost interest in her hobbies and was convinced that she would not be able to work again. She thought life was not worth living and has consumed 60 tablets of phenobarbitone to end her life. She is most likely suffering from:

 A

Adjustment disorder

 B

Conversion disorder

 C

Depressive disorder

 D

Post-traumatic stress disorder (PTSD)

Ans. A

Explanation:

Adjustment disorder is a reaction to an identifiable psychosocial stressor, that leads to maladaptive reactions including impairment in occupational functioning and symptoms that are in excess of normal and expected reaction to this stressor.

Symptoms of adjustment disorder with depressed mood includes tearfulness and feelings of hopelessness.

Symptoms develop in response to an identifiable stressor within 3 months.

Ref: Principles and Practice of Geriatric Psychiatry Edited By Mohammed T. Abou-Saleh, 3rd Edition, Page 70 ; Clinical Guide to The Diagnosis and Treatment of Mental Disorders By Michael B. First, 2nd Edition, Page 395 ; Counseling for Post Traumatic Stress Disorder By Michael J Scott, 3rd Edition, Page 8


Q. 2

A 45 year old father presents with sleep deprivation, lethargy headache, and low mood two months after knowing that his son is suffering from leukemia. He interacts reasonably well with others, but has absented himself from work. Which of the following is the most probable diagnosis?

 A

Depression

 B

Adjustment disorder

 C

Somatisation disorder

 D

Psychogenic headache

Q. 2

A 45 year old father presents with sleep deprivation, lethargy headache, and low mood two months after knowing that his son is suffering from leukemia. He interacts reasonably well with others, but has absented himself from work. Which of the following is the most probable diagnosis?

 A

Depression

 B

Adjustment disorder

 C

Somatisation disorder

 D

Psychogenic headache

Ans. B

Explanation:

The patient in question has an identifiable stress in the form of his son suffering from leukemia.
After this identifiable stress this patient developed symptoms of lethargy, low moods, headache, sleep deprivation, and started missing work. Since the symptoms appeared within 3 months of the onset of stressor, a diagnosis of adjustment disorder is most likely.
 
DSM IV Diagnostic criteria for adjustment disorder includes:
Development of emotional or behavioral symptoms in response to an identifiable stressor occurring within 3 months of onset of the stressor.

 

These symptoms are clinically significant as evidenced by the following:

  • Marked distress that is in excess of what would be expected from exposure to the stressor
  • Significant impairment in social or occupational functioning
  • Stress related disturbance does not meet the criteria for another specific Axis I disorder and is not  merely an exacerbation of a pre existing Axis I or Axis II disorder
  • The symptoms does not represent bereavement
  • Once the stressor has terminated, the symptoms do not persist for more than additional 6months
It is said to be acute when the disturbance last for less than 6months and chronic if disturbance last for more than 6 months.
 
Ref: Psycho-Oncology By Jimmie C. Holland, 2nd Edition, Page 304; Lippincott’s Primary Care Psychiatry By Robert M. McCarron

Quiz In Between



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