Adjustment disorders as stress-related disorders: Prevalences from a representative community survey

Abstract

Stress-related disorders have been conceptualised as a nosological group comprising Adjustment Disorders (AJDs), Posttraumatic Stress Disorder (PTSD), and Complicated Grief Disorder(CGD). A used a recently proposed diagnostic model that describes AJDs as stress-related disorder (Maercker et al., Psychopathology, Vol. 40, No. 2).A representative sample of a total of 712 elderly persons from Zurich aged 65-96 years were assessed by standardized interview or self-report questionnaires for occurrence of stressful index events and subsequent disorders: AJDs, PTSD, Major Depressive Disorder (MDD), and Recurrent Brief Depression (RBD). PTSD was assessed according to DSM-IV criteria, MDD was operationalised by CES-D criteria.Index events for adjustment disorders were indicated by 52%, with 2.3% current adjustment disorder of any subtype. 36% of participants reported traumatic events meeting the DSM A1 criterion with 0.7% full and 4% subthreshold PTSD in the sample. CES-D depression prevalence was 6%, MDD 2.3%, and RBD 3%. Only AJDs and MDD were significantly associated with comorbid disorders. Health care utilisation (pharmacological or psychological treatment) were low for all diagnoses (< 25%) with relatively more psychotherapy for PTSD and more pharmacotherapy for CG.As this study was conducted in a sample of the elderly, further research should investigate syndrome criteria and prevalences in other age groups.