ICD-11 Adjustment Disorder among Organ Transplant Patients and Their Relatives

Abstract

Adjustment disorder (AD) is one of the most frequent mental health conditions after stressful life experiences in the medical setting. The diagnosis has been conceptually redefined in International Classification of Diseases (ICD-11) and now includes specific symptoms of preoccupations and failure to adapt. The current study assesses the prevalence of self-reported ICD-11 AD among organ transplantation patients and their relatives, explores the association of patients’ demographic-, transplant-, and health-related characteristics and ICD-11 AD symptoms, and evaluates the role of social support in the post- transplant context. A total of N = 140 patient-relative dyads were examined cross-sectionally. Hierarchical linear regression analyses were conducted to explore potential predictive factors of AD. The results revealed an AD prevalence of 10.7% among patients and 16.4% among relatives at an average of 13.5 years after the transplantation. The time that had passed since the transplantation was unrelated to AD symptom severity. Women tended to be at a higher risk in both groups. Somatic issues were predictive for AD only among patients and social support was predictive mainly among relatives. The results suggest that ICD-11 AD is a relevant diagnosis after organ transplantations for patients and relatives and its specific symptom clusters may provide important information for developing intervention strategies.

Being a parent, emotional stability, and adjustment disorder symptoms in the face of COVID‐19

“…An adjustment disorder is a psychiatric condition in which the person does not adapt sufficiently to a stressful situation and develops symptoms that in some cases require intervention. Adjustment disorder has been found in the prevalence of 7%–12% in the general population (Ben‐Ezra et al, 2020 ), but in even more alarming prevalence of up to 23% in populations that were exposed to acute stress, such as among people who lost their job involuntarily, organ transplant patients and their relatives, or people who faced the current global pandemic (Bachem et al, 2019 ; Perkonigg et al, 2018 ; Rossi et al, 2020 ). According to the International Classification of Diseases and Related Health Problems (ICD‐11; World Health Organization, 2022 ), adjustment disorder is a maladaptive response to a stressful event or a combination of stressful life situations, changes, or ongoing psychosocial difficulties.…”

Validation of the International Adjustment Disorder Questionnaire in Israel and Switzerland

“…Other validated versions of the ADNM include a brief 8‐item version, consisting of only the core symptoms (ADNM‐8; Kazlauskas et al, 2018) and an ultra‐brief measure consisting of only two items of preoccupation and two items of failure to adapt (ADNM‐4; Ben‐Ezra, Mahat‐Shamir, et al, 2018). The ADNM questionnaire has been used as a general measure assessing stress response to any stressful life event a person identifies from the list of 18 acute and chronic life events in general population samples (Glaesmer et al, 2015; Zelviene et al, 2017) but also as a contextualized questionnaire to assess maladaptive reactions to specific events such as job loss (Lorenz et al, 2020), burglary (Bachem & Maercker, 2016), terror attacks (Ring et al, 2018) or organ transplantations (Bachem et al, 2019).…”

Prevalence of Mental Disorders in a German Kidney Transplant Population: Results of a KTx360°-Substudy

“…In 40% of the patients, these stress-related disorders were associated with events around the kidney disease, the treatment, or the transplantation process. Bachem et al ( 2019 ) evaluated the frequency of adjustment disorders based on ICD-11 criteria in a sample of organ transplant recipients using a self-rating questionnaire. The 140 participants were recruited through a self-help group, and 10.7% fulfilled the criteria for current adjustment disorder with the disease or its treatment as the initiating stressor.…”

“…In our sample, the prevalence of adjustment disorder was much lower at 5%, and of those, only about 40% were associated with experiences and events associated with the disease and its treatments. However, the diagnoses in the study of Bachem et al ( 2019 ) were made based on questionnaires. Additionally, the diagnostic criteria have changed between ICD-10 and ICD-11.…”