From the Guidelines
Yes, adults can definitely have adjustment disorder. Adjustment disorder is a stress-related condition that occurs when a person has difficulty coping with a stressful life event such as job loss, relationship problems, illness, or major life transitions. It's characterized by emotional or behavioral symptoms that develop within three months of the stressor and cause significant distress or impairment in functioning, as defined in the Journal of Clinical Oncology 1. In adults, symptoms may include anxiety, depressed mood, conduct disturbances, or a combination of these.
Key Characteristics of Adjustment Disorder
- Emotional or behavioral symptoms in response to an identifiable stressor(s) occurring within 3 months of the onset of the stressor(s) 1
- Symptoms include low mood, tearfulness, or feelings of hopelessness, or anxiety, nervousness, worry, jitteriness, or separation anxiety in the presence of the major stressor 1
- Significant impairment in social, occupational, or other important areas of functioning 1
Treatment and Management
Treatment typically involves psychotherapy, particularly cognitive-behavioral therapy or brief solution-focused therapy, to develop better coping skills. Sometimes, short-term medication may be prescribed to manage specific symptoms like anxiety or insomnia, such as benzodiazepines like lorazepam (0.5-2mg as needed) or antidepressants like sertraline (50-200mg daily) if depression is prominent, as suggested by the Journal of the National Comprehensive Cancer Network 1. Most cases of adjustment disorder resolve within six months once the stressor ends or the person adapts to the situation. However, if symptoms persist beyond this timeframe, a different diagnosis might be considered.
Importance of Early Intervention
Adjustment disorder is quite common in adults and is actually more frequently diagnosed in adults than in children or adolescents due to the complex life challenges adults typically face. Early intervention and appropriate management can significantly improve outcomes in terms of morbidity, mortality, and quality of life. The American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation also emphasize the importance of addressing adjustment to chronic health conditions, such as coronary heart disease, through individual and group education and counseling 1.
From the Research
Adjustment Disorder in Adults
- Adjustment disorder is a common psychiatric disorder that can affect adults, as evident from a systematic review of psychological and pharmacological treatments for adjustment disorder in adults 2.
- The review found that the majority of studies (59%) investigated psychological therapies, with cognitive behavioral therapy (CBT) being the most common component (53%) 2.
- Despite several randomized controlled trials, the quality of the evidence for positive effects of all psychological and pharmacological treatments on symptoms of adjustment disorder was ranked as low to very low 2.
Treatment of Adjustment Disorder
- While there is limited research specifically on adjustment disorder, studies on anxiety and depression may provide some insights, as these conditions often co-occur with adjustment disorder 3, 4, 5, 6.
- Selective serotonin reuptake inhibitors (SSRIs) and cognitive behavioral therapy (CBT) are commonly used treatments for anxiety and depression, and may also be effective for adjustment disorder 3, 4, 5, 6.
- Combining SSRIs and CBT may produce greater improvement than either treatment alone, although the additive benefit of CBT may emerge later in treatment 5, 6.
Key Findings
- Adults can experience adjustment disorder, and psychological therapies such as CBT may be effective in reducing symptoms 2.
- SSRIs and CBT may also be effective for adjustment disorder, although more research is needed to confirm this 3, 4, 5, 6.
- The quality of the evidence for treatments of adjustment disorder is generally low to very low, highlighting the need for further research 2.