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Adjustment disorders: prevalence in a representative nationwide survey in Germany

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Objectives

This is the first study to estimate the prevalence of adjustment disorder (AjD) in the general population. A new conceptualisation of AjD as a stress response syndrome was applied, which allowed AjD to be assessed directly from its symptom profile, including intrusive, avoidance and failure-to-adapt symptoms (Maercker et al., Psychopathology 40:135–146, 2007).

Methods

Prevalence rates of distressing life events and AjD were estimated from a representative sample of the German general population (n = 2,512) with a broad age range (14–93 years). A questionnaire including a life events checklist and self-rating questions that assessed AjD symptoms and symptom duration were personally handed out by an interviewer.

Results

The prevalence of AjD fulfilling the criterion of clinically significant impairment was 0.9%; a further 1.4% of the sample was diagnosed with AjD without fulfilling the impairment criterion. In ~72.5% of AjD cases, symptoms had developed 6–24 months prior to assessment. AjD was most often associated with acute events such as moving or chronic stressors such as serious illness, conflicts at the respondent’s job or with friends or neighbours (with ~5% conditional probability each).

Conclusions

The results correspond with the few other studies that have examined the prevalence of AjD, even though a new conceptualisation of the disorder was used. Explorative results regarding the duration of AjD syndromes and symptoms call for further redefinition and empirical investigation of this under-researched mental condition.

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Conflict of interest

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Author information

Authors and Affiliations

  1. Department of Psychology, University of Zurich, Binzmuhlestr. 14, 8050, Zurich, Switzerland

    Andreas Maercker, Simon Forstmeier & Laura Pielmaier

  2. Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany

    Lena Spangenberg, Elmar Brähler & Heide Glaesmer

Authors
  1. Andreas Maercker
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  2. Simon Forstmeier
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  3. Laura Pielmaier
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  4. Lena Spangenberg
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  5. Elmar Brähler
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  6. Heide Glaesmer
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Corresponding author

Correspondence to Andreas Maercker.

Appendix

Appendix

Adjustment disorders symptom clusters and symptom criteria assessed in the study.

  • Intrusions

    • Repetitive thoughts

    • Stressful thinking about it

    • Constant reminders

    • Unable to stop memories.

  • Avoidance

    • Avoiding reminders

    • Abolishing stressful thoughts

    • Suppressing feelings

    • Not talking about stressor.

  • Failure to adapt

    • More difficulties concentrating

    • Trouble sleeping since stressor

    • Not keen to perform necessary tasks.

  • Depressive mood

    • Low/sad

    • Fewer enjoyable activities

    • Feeling dispirited.

  • Anxiety

    • Anxiety when thinking of stressor

    • Fear of certain situations.

  • Impulse disturbance

    • Quicker to lose one’s temper

    • More irritable

    • Nervous and restless.

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Maercker, A., Forstmeier, S., Pielmaier, L. et al. Adjustment disorders: prevalence in a representative nationwide survey in Germany. Soc Psychiatry Psychiatr Epidemiol 47, 1745–1752 (2012). https://doi.org/10.1007/s00127-012-0493-x

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  • DOI: https://doi.org/10.1007/s00127-012-0493-x

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