Prevalence Of Adjustment Disorders Research Articles

Pandemic-induced increase in adjustment disorders among postpartum women in Germany

BackgroundThe current paper analyzed the effect of the pandemic-induced lockdown on maternal mental health during the first 12 postpartum weeks in Germany.MethodsIn this cohort study, we compared the participants’ anamnestic backgrounds and the results of psychological tests, measuring stress levels, depressive symptoms and attachment. The 327 participants were divided into two groups with one representing the “pre-COVID” sample and the other the “lockdown” sample. We performed multiple comparisons, investigating the distribution of diagnoses and the correlating risk profiles between the two cohorts.ResultsOur analysis showed a significant difference between the two cohorts, with a 13.2% increase in the prevalence of adjustment disorders (AD), but not postpartum depression (PPD), in the first 12 weeks postpartum. However, during the pandemic, women with AD had fewer risk factors compared to their pre-pandemic counterparts. In the “lockdown” cohort, a tendency toward higher stress and lower mother-child attachment was observed in AD.ConclusionsIn sum, we observed some negative impact of the pandemic on maternal mental health. The lockdown might have contributed to an increase in the number of cases involving AD in the postpartum period. The prevalence of PPD (ca. 6–10%), on the other hand, was not affected by the lockdown. Thus, the effect of COVID-19 on maternal mental health might not, after all, have been as severe as assumed at the beginning of the pandemic.

Prevalence of depressive, bipolar and adjustment disorders, in Quebec, Canada

BackgroundThe prevalence of mood disorders was estimated at 5.4% according to the latest Canadian survey. It has been suggested to use administrative data and self-reported data to optimize the estimation for mental health care in the population. Using administrative data, algorithms (combination of codes from the International Classification of Diseases) had been previously developed to identify the population with mood and anxiety disorders. However, the specific prevalence of each component of mood disorders (depressive, bipolar and adjustment disorders) are still unknown in Quebec, Canada. ObjectiveTo 1) identify the population diagnosed respectively with depressive, bipolar and adjustment disorders in administrative data, and 2) provide annual prevalence estimates of each component. MethodData were extracted from the Quebec Integrated Chronic Disease Surveillance System and the entire population of Quebec (2000–2017) was included in this study (8.3 million; 2017). The prevalence of depressive, bipolar and adjustment disorders were estimated using specific algorithms. ResultsThe annual prevalence of depressive disorders was 3.7% in 2000–2001; it decreased to 2.8% in 2016–2017. In comparison, the prevalence of bipolar disorders was 0.8% in 2000–2001, decreasing to 0.6% in 2016–2017, and the prevalence of adjustment disorders was 1.3% in 2000–2001 and increased to 1.6% in 2016–2017. ConclusionUsing specific algorithms, we observed that the trend of adjustment disorders is increasing while trends of depressive and bipolar disorders are decreasing. Further studies should assess if the related burden of care respectively follows the same trends as policy makers’ allocations of resources may need to be adapted.

Psychological defense mechanisms among individuals with SCI with adjustment disorder

Objectives: The used psychological defense styles among individuals with spinal cord injury (SCI) with adjustment disorders (AJD) have not yet been described. In the present investigation, the prevalence of AJD among people with SCI has been estimated and the pattern of used defense styles has been identified.Design: Cross-sectional investigation.Setting: A tertiary rehabilitation center in Iran.Participants: Individuals referred to Brain and Spinal Cord Injury Research Center were invited to participate in a screening interview. AJD was diagnosed based on DSM-V criteria. Those with AJD diagnosis were scheduled for another interview to assess defense mechanisms.Outcome measures: Demographic and injury-related variables were recorded. Defense mechanisms were assessed by the 40-item version of the Defense-Style Questionnaire (DSQ-40).Results: Among 114 participants, 32 (28%) were diagnosed with AJD among whom 23 subjects attended the second interview. Mean age and time since injury were 29.57 ± 9.29 years and 11.70 ± 6.34 months, respectively. The majority of patients were using idealization defense mechanism (91.3%). In the second and third place, passive aggression (87.0%) and somatization (82.6%) defense mechanisms were observed, respectively. Neurotic style was dominantly used (11.52 ± 2.26). Sex, marital status, educational level, cause of the injury and injury level were not related to defense style (P: 0.38, 0.69, 0.88, 0.73, and P: 0.32, respectively).Conclusion: Prevalence of AJD is estimated to be 28% among individuals with SCI. The most prevalent defense style was neurotic and the dominant used defense mechanism was “idealization.” The role of demographic and injury-related variables in determining the used defense mechanisms was insignificant.

Psychiatrists admitted to a physicians' health programme.

Psychiatrists are at a high risk of becoming mentally ill at some point during their careers. To compare the profile of psychiatrists admitted to the Barcelona Physicians' Health Programme (PHP) with other sick doctors in the programme. A retrospective case review of electronic medical records was conducted for physicians registered at the 'Colegio de Médicos' in Barcelona and consecutively admitted to the Barcelona PHP from January 1998 until December 2013. One thousand two hundred eighteen records were reviewed. The 72 psychiatrists admitted to the programme were not statistically different from the other physicians in gender (54% versus 51% women), primary diagnosis (34% non-substance use mental disorders versus 29% substance use disorders), prevalence of adjustment disorders and median length of their first treatment episode (9.0 versus 8.4 months). Psychiatrists were significantly older (mean age 53 versus 50 years; t = 2.12; P < 0.05), more frequently had inpatient treatment during their first treatment episode (17% versus 10%; χ (2) = 4.57, P < 0.05) and had more referred (rather than self-referred) admissions (22% versus 13%; χ (2) = 4.57, P < 0.05) than other physicians. However, only the type of referral played a significant role when considering the simultaneous effect of all relevant variables (Wald = 4.43; P < 0.05). Psychiatrists with mental disorders may be more reluctant to ask for help from a PHP voluntarily than other physicians. Members of this professional group should be encouraged to seek help when affected by mental distress or addiction problems.

Development and validation of the Diagnostic Interview Adjustment Disorder (DIAD)

Adjustment disorders (ADs) are under-researched due to the absence of a reliable and valid diagnostic tool. This paper describes the development and content/construct validation of a fully structured interview for the diagnosis of AD, the Diagnostic Interview Adjustment Disorder (DIAD). We developed the DIAD by partly adjusting and operationalizing DSM-IV criteria. Eleven experts were consulted on the content of the DIAD. In addition, the DIAD was administered by trained lay interviewers to a representative sample of disability claimants (n = 323). To assess construct validity of the DIAD, we explored the associations between the AD classification by the DIAD and summary scores of the Kessler Psychological Distress 10-item Scale (K10) and the World Health Organization Disability Assessment Schedule (WHODAS) by linear regression. Expert agreement on content of the DIAD was moderate to good. The prevalence of AD using the DIAD with revised criteria for the diagnosis AD was 7.4%. The associations of AD by the DIAD with average sum scores on the K10 and the WHODAS supported construct validity of the DIAD. The results provide a first indication that the DIAD is a valid instrument to diagnose AD. Further studies on reliability and on other aspects of validity are needed.

P-1155 - Integrated psychotherapy of adjustment disorders in university students

Introduction Intensive stress caused by academic pressure and psychosocial challenges for the freshmen leads to the high prevalence of adjustment disorders. Integrated psychotherapy for students is a part of a complex multistage programme of mental health promotion in University. Objectives To identify adjustment disorders and stress factors among students in one of the Moscow Universities and to provide an appropriate mental heath care using an integrated psychotherapy. Aims To investigate the factors of mental health improvement under the psychotherapy in adjustment disorders. Methods 20 1st year students were examined by structured interview, Spilberger scales, J, Amirkhan test on type of coping strategies. For the rehabilitation purposes an integrated schema consisting of elements of CBT, Interpersonal psychotherapy, Gestalt therapy, psychodynamics was used. Results Positive dynamic in 15 cases were associated with improving skills of self regulation, activating of interpersonal interaction and with actual needs and individual purposes identifying. Conclusions The importance of emotional identification by patients as well as positive thinking, more differentiated attitude to the stress situations and working out the effective stress coping strategies were specified as facilitating factors. More confident behavior which was one of the most therapeutic requests has also meaning for enriching of person's resources.

Can adjustment disorder and depressive episode be distinguished? Results from ODIN

Background No large-scale epidemiological study has included adjustment disorders (AD) for consideration yet it is considered to be a common psychiatric diagnosis. Methods Using a two stage screening method, those above a threshold score for possible caseness on the Beck Depression Inventory (BDI), were interviewed using SCAN to identify those with depressive episode and AD. Variables that might distinguish AD from depressive episode were examined. Results The prevalence of AD was extremely low with one centre having no cases. Finland, the country with the highest prevalence, only achieved a frequency of 0.8% and 1%, respectively, for urban and rural sites. Logistic regression failed to identify any variables that independently differentiated AD from depressive episode. Findings relating to severity of symptoms using BDI were robust. Limitations The small sample size might have contributed to a failure to identify distinguishing features between AD and other disorders. Conclusions Reasons for the failure of even robust results, such as BDI severity, to distinguish AD from depressive episode are considered of which problems in conceptualising AD are the most likely. Further studies are required.

Mental Disorders in Adolescent Suicide

The prevalence of mental disorders (DSM-III-R Axes I and II) among adolescent suicide victims (n = 53) was investigated in a nationwide psychological autopsy study in Finland. The data were collected comprehensively through interviews of the victims' relatives and attending health care personnel and from official records. Following independent assessment by two psychiatrists, the DSM-III-R diagnoses were assigned in consensus meetings. A large majority of the victims (94%) suffered from a mental disorder. The most prevalent disorders were depressive disorders (51%) and alcohol abuse or dependence (26%). The prevalence of adjustment disorders (21%) was higher than in most studies from other countries. Personality disorder was diagnosed in 32% of the cases. Comorbidity was found in 51% of the victims. The results indicate a strong relatedness between adolescent suicide and the presence of depression, antisocial behavior, and alcohol abuse.