Adjustment Disorder: A Multisite Study of its Utilization and Interventions in the Consultation-Liaison Psychiatry Setting

Strain, James J.; Smith, Graeme C.; Hammer, Jeffrey S.; McKenzie, Brian; Blumenfield, Michael; Muskin, Philip R.; Newstadt, Geoffrey; Wallack, Joel J.; Wilner, Ascher; Schleifer, Steven S

doi:10.1016/s0163-8343(98)00020-6

Cited by 157 publications

(93 citation statements)

References 24 publications

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“…In line with other reports, adjustment disorders were also frequently diagnosed among referred patients (14% prevalence in our sample) [22,23]. Despite the common tendency to minimize the clinical significance of Adjustment Disorders, recent research has shown that this is an important and timeconsuming diagnostic category in C-L psychiatry practice [24]. Organic mental syndromes, especially delirium, were diagnosed in about 10% of referred patients.…”

Section: Discussionsupporting

confidence: 90%

A multicenter investigation of consultation-liaison psychiatry in Italy

Gala¹,

Rigatelli²,

Bertolini³

et al. 1999

General Hospital Psychiatry

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Section: Discussionsupporting

confidence: 90%

A multicenter investigation of consultation-liaison psychiatry in Italy

Gala¹,

Rigatelli²,

Bertolini³

et al. 1999

General Hospital Psychiatry

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“…Up to 12% of referrals to that service in several university hospitals 18 were so diagnosed and it was considered a rule-out diagnosis in a further 10.6%, figures that resemble those of a large European study that identified AD as the primary diagnosis from 56 centres across 11 European countries 19 . However the frequency with which AD is diagnosed in this setting seems to be declining in tandem with an increase in the diagnosis of major depression 20 .…”

Section: Consultation Liaison Psychiatrymentioning

confidence: 86%

“…Finally the question of the setting in which these interventions should be delivered is important and while it might be tempting to redirect those with AD's from the specialist services back to their primary care physicians, the demands in terms of time 70 and skills might make this impractical. Management in a community setting in which large numbers are offered an intervention delivered by clinical psychologists is another possibility.…”

Section: Pharmacological Interventionsmentioning

confidence: 99%

Adjustment Disorder

Casey

2009

CNS Drugs

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Adjustment disorder (AD) was introduced into the psychiatric classification systems almost thirty years ago although the concept was recognised for many years before that. Six subtypes are described based on the predominant symptoms but no further diagnostic criteria are offered to assist the clinician. These are common conditions especially in primary care and in consultation liaison psychiatry where the prevalence ranges from 11-18% and 10-35% respectively. Yet they are under-researched, possibly due to the failure of some of the common diagnostic tools to allow for the diagnosis of AD. Among those to incorporate AD, the concordance between the clinical and interview diagnosis is very poor with the diagnosis being made more commonly in clinical practice than the diagnostic tools allow for. AD is found in all cultures and in all age groups.

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“…AD is a diagnosis that has been shown to be common in primary care populations (Blacker and Clare 1988), in out-patient and in-patient samples (APA 1994) as well as in certain subgroups such as those involved in deliberate self-harm (Schnyder and Valach 1997) and those with physical illness (Strain et al 1998). It was therefore anticipated that it would be a relatively common diagnosis.…”

Section: Discussionmentioning

confidence: 99%

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

Casey

Maracy

Kelly

et al. 2006

Journal of Affective Disorders

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Publication informationJournal of Affective Disorders, 92 (2-3): 291-297 AbstractBackground: 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 center 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. 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 conceptualizing AD are the most likely. Further studies are required.

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Adjustment Disorder: A Multisite Study of its Utilization and Interventions in the Consultation-Liaison Psychiatry Setting

Cited by 157 publications

References 24 publications

A multicenter investigation of consultation-liaison psychiatry in Italy

A multicenter investigation of consultation-liaison psychiatry in Italy

Adjustment Disorder

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

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