Abstract
Background: Adjustment disorder (AD) is a condition commonly encountered by clinicians in emergency departments and liaison psychiatry settings and has been frequently reported among patients presenting with suicidal behaviours. A number of previous studies have noted the strong association between suicidal ideation and behaviours, and AD. In this paper, we aimed to explore this relationship, by establishing the incidence of AD in patients who present with self-harm and suicidal ideation, and the rates of self-harm among patients with a diagnosis of AD. Methods: We conducted a review of the literature of well-established databases using specific key words then synthesised the results into a descriptive narrative as well as representing it in table form. Results: Sample sizes and study methods varied significantly across the review. A majority of studies were retrospective chart-based reviews, and only three used structured diagnostic instruments. A high prevalence of AD (ranging from 9.8 to 100%) was found, with self-poisoning representing the most common form of suicide attempt in the majority of studies. Interpersonal difficulties were the main precipitant in studies which examined this. Conclusions: This study suggests there is a strong association between AD and suicidal behaviours. Given the paucity of research in the area, there is a need to build the evidence base for effective treatment strategies.
Highlights
Adjustment disorder (AD) is a condition which is characterised by the development of symptoms, usually of depression or anxiety, in response to a stressful event [1]
This condition is frequently diagnosed in patients attending Emergency Departments (EDs) and liaison psychiatry settings, and in particular, has been commonly reported among patients presenting with suicidal behaviours, including self-harm
In this study we aimed to examine the association between suicidal ideation and behaviours in AD in an acute medical hospital setting
Summary
Adjustment disorder (AD) is a condition which is characterised by the development of symptoms, usually of depression or anxiety, in response to a stressful event [1]. This condition is frequently diagnosed in patients attending Emergency Departments (EDs) and liaison psychiatry settings, and in particular, has been commonly reported among patients presenting with suicidal behaviours, including self-harm. Suicidal ideation and behaviours may be a feature of a number of psychiatric disorders and are an important symptom, diagnostic criterion, in depression [2]. A diagnosis of AD requires the identification of a precipitating stressor, and symptoms must resolve within six months of the termination of the stressor. Conclusions: This study suggests there is a strong association between
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