A descriptive study of adjustment disorder diagnoses in general hospital patients

Abstract

Abstract Objective: A descriptive survey of the characteristics of medical and surgical patients given the diagnosis of adjustment disorder. Method: 124 case notes of patients with adjustment disorder diagnoses seen over a one year period in a tertiary care hospital were reviewed to describe their characteristics. Patient demographic data, medical illness, hospitalisation details and psychiatric consultation notes were examined. Results: This diagnosis represented 18.5% of consultation-liaison referrals. The length of hospitalisation for the adjustment disorder patients was more than twice that of general medical admissions. At least one psychosocial stressor was noted in 93% of all patients; in 59% of patients the medical illness was one of the stressors noted. About a third of patients had a past psychiatric history. Only 9% of patients had new courses of antidepressants recommended and in only 2% was inpatient psychiatric admission required. The diagnosis was used especially in patients with serious medical conditions, self-harm, injury and poisoning, and in cases presenting with a mixture of somatic and psychic symptoms. Conclusions: The results suggest that this is a commonly used diagnosis in the medical consultation setting; it is largely being used in a way consistent with DSM criteria, whilst there were indications that it was also used for a range of problem behaviours that are difficult to classify.