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An adjustment disorder (AD) (sometimes called exogenous, reactive, or situational depression)〔Souza, Thomas A. ''Differential Diagnosis and Management for the Chiropractor: Protocols and Algorithms''. 4th ed. Sudbury, Mass.: Jones and Bartlett, 2009. 587. Print.〕 occurs when an individual is unable to adjust to or cope with a particular stress or a major life event. Since people with this disorder normally have symptoms that depressed people do, such as general loss of interest, feelings of hopelessness and crying, this disorder is sometimes known as situational depression. Unlike major depression the disorder is caused by an outside stressor and generally resolves once the individual is able to adapt to the situation.〔(An Introduction to Adjustment Disorder ). Archived from (the original ) on 2012-09-18.〕 One hypothesis for adjustment disorder is that it may represent a sub-threshold clinical syndrome.〔Adjustment disorders. Retrieved from http://journals.scholarsportal.info/details?uri=/14761793/v05i0007/240_ad〕 The condition is different from anxiety disorder, which lacks the presence of a stressor, or post-traumatic stress disorder and acute stress disorder, which usually are associated with a more intense stressor. Common characteristics of adjustment disorder include mild depressive symptoms, anxiety symptoms, and traumatic stress symptoms or a combination of the three. There are nine types of adjustment disorders listed in the DSM-III-R. According to the DSM-IV-TR, there are six types of adjustment disorders, which are characterized by the following predominant symptoms: depressed mood, anxiety, mixed depression and anxiety, disturbance of conduct, mixed disturbance of emotions and conduct, and unspecified. However, the criteria for these symptoms are not specified in greater detail.〔Patricia, C.(2009). Adjustment Disorder: Epidemiology, Diagnosis and Treatment〕 Adjustment disorder may be acute or chronic, depending on whether it lasts more or less than six months. According to the DSM-IV-TR, if the adjustment disorder lasts less than 6 months, then it may be considered acute. If it lasts more than six months, it may be considered chronic.〔 Moreover, the symptoms cannot last longer than six months after the stressor(s), or its consequences, have terminated.〔Reference-Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition, American Psychiatric Association, p.679〕 Diagnosis of adjustment disorder is quite common; there is an estimated incidence of 5%–21% among psychiatric consultation services for adults. Adult women are diagnosed twice as often as are adult men. Among children and adolescents, girls and boys are equally likely to receive this diagnosis.〔Diagnostic and Statistical Manual of Mental Disorders – Fourth edition, American Psychiatric Association, p. 681〕 Adjustment disorder was introduced into the psychiatric classification systems almost 30 years ago, but the concept was recognized for many years before that.〔p. 279 〕 ==Signs and symptoms== According to the DSM IV-TR, the development of the emotional or behavioral symptoms of this diagnosis have to occur within three months of the onset of the identifiable stressor(s).〔Rapport, J., & Ismond, D. (1990). DSM IV training guide for diagnosis of childhood disorders. New York: Brunner/Mazzel, 260〕 Some emotional signs of adjustment disorder are * Sadness * Hopelessness * Lack of enjoyment * Crying spells * Nervousness * Anxiety * Worry * Desperation * Trouble sleeping * Difficulty concentrating * Feeling overwhelmed and thoughts of suicide Some behavioral signs of AD are * Fighting * Reckless driving * Ignoring important tasks such as bills or homework * Seeking approval from others by any way possible (cheating/lying/escaping reality) * Avoiding family or friends * Performing poorly in school * Skipping school * Vandalizing property.〔Adjustment disorder: Symptoms (2011, March 17). Retrieved from http://www.mayoclinic.com/health/adjustment-disorders/DS00584/DSECTION=symptoms〕 However, the stress-related disturbance does not only exist as an exacerbation of a pre-existing axis I or axis II disorder and cannot be diagnostic as axis 1 disorder.〔Bisson JI, Sakhuja D. (2006). "Adjustment disorders". ''Psychiatry'' 5 (7): 240-242. 〕 Suicidal behavior is prominent among people with AD of all ages, and up to one-fifth of adolescent suicide victims may have an adjustment disorder. Bronish and Hecht (1989) found that 70% of a series of patients with AD attempted suicide immediately before their index admission and they remitted faster than a comparison group with major depression.〔Bronish, T., & Hecht, H. (1989). Validity of adjustment disorder, comparison with major depression. Journal of Affective Disorders, 17, 229–236.〕 Asnis et al. (1993) found that AD patients report persistent ideation or suicide attempts less frequently than those diagnosed with major depression.〔Asnis, G. M., Friedman, T. A., Sanderson, W. C., Kaplan, M. L., van Praag, H. M., & Harkavy-Friedman, J. M. (1993). Suicidal behavior in adult psychiatric outpatients: Description and prevalence. American Journal of Psychiatry, 150, 108–112.〕 According to a study on 82 AD patients at a clinic, Bolu et al. (2012) found that 22 (26.8%) of these patients were admitted due to suicide attempt, consistent with previous findings. In addition, it was found that 15 of these 22 patients chose suicide methods that involved high chances of being saved.〔Bolu, A., Doruk, A., Ak, M., Özdemir, B., & Özgen, F. (2012). Suicidal behavior in adjustment disorder patients. Dusunen Adam, 25(1), 58–62.〕 Henriksson et al. (2005) states statistically that the stressors are of one-half related to parental issues and one-third in peer issues.〔Henriksson, M; Lönnqvist, J; Marttunen, M; Pelkonen, M; (2005). Suicidality in adjustment disorder: Clinical characteristics of adolescent outpatients. ''European Child & Adolescent Psychiatry'' 14 (3), pg. 174–180 〕 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Adjustment disorder」の詳細全文を読む スポンサード リンク
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