Die Diagnose im Nachgang: Eine Rehabilitierung der Anpassungsstörung*

Übersicht

Zusammenfassung

Obwohl eine häufig gestellte Diagnose erfährt die Anpassungsstörung wenig wissenschaftliche Aufmerksamkeit und stattdessen liegt der Fokus auf der„Major Depression“. Es scheint, dass Anpassungsstörung und Major Depression verschmolzen sind. Die Gründe hierfür sollen hier untersucht werden. Eine klare Unterscheidung zu treffen hat allerdings entscheidende therapeutische und finanzielle Auswirkungen.

Schlüsselwörter

Anpassungsstörung Major Depression 

The ‘afterthought’ diagnosis: rehabilitating adjustment disorder

Abstract

Although a common diagnosis, adjustment disorder has received little scientific attention and instead the focus has been on major depression. It is likely that adjustment disorder and major depression have been conflated and the reasons for this are explored. Clearly delineating one from the other has crucial therapeutic and financial implications.

Keywords

adjustment disorder major depression 

Literatur

  1. 1.
    American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd. Edition), American Psychiatric Association, WA, USAGoogle Scholar
  2. 2.
    American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th. Edition) American Psychiatric Association, WA, USAGoogle Scholar
  3. 3.
    Andrews G, Slade T, Peters L. (1999) Classification in psychiatry: ICD-10 versus DSM-IV. Br. J. Psych. 174:3-5Google Scholar
  4. 4.
    Ayuso-Mateos JL, Vazquez-Barquero JL, Dowrick C. et al. (2001) Depressive disorders in Europe: prevalence figures from the ODIN study. Br. J. Psych. 179:308-316Google Scholar
  5. 5.
    Blacker CVR Clare AW (1988) The prevalence and treatment of depression in general practice. Psychopharmacology 95:14-17Google Scholar
  6. 6.
    Bronish T (1991) Adjustment reactions, a long-term prospective study and retrospective follow-up study of former patients in a crisis intervention ward. Acta Psychiatr. Scan. 84:86-93Google Scholar
  7. 7.
    Casey PR, Dillon S Tyrer P (1984) The diagnostic status of patients with conspicuous psychiatric morbidity in primary care. Psychol. Med. 14:673-681Google Scholar
  8. 8.
    Casey PR, Dowrick C, Wilkinson G. (2001) Adjustment disorders: fault line in the psychiatric glossary. Br. J. Psych. 179:479-481Google Scholar
  9. 9.
    Casey PR, Maracy M, Kelly B et al. (2006) Can adjustment disorder and depressive episode be distinguished. Results from the ODIN study. Journal of Affective Disorders 92:291-297Google Scholar
  10. 10.
    Despland JN, Monod L, Ferrero F (1995) Clinical relevance of adjustment disorder in DSM-III and DSM-IV. Compr. Psych. 36:454-460Google Scholar
  11. 11.
    Fabrega H, Mezzich J. (1987) Adjustment disorder and psychiatric practice: cultural and historical aspects. Psychiatry 50:31-49Google Scholar
  12. 12.
    Fard F, Hudgens RW, Welner A. (1979) Undiagnosed psychiatric illness in adolescents: a prospective study. Arch. Gen. Psych. 35:279-281Google Scholar
  13. 13.
    First MB, Spitzer RL, Williams JW et al. (1995) Structured Clinical Interview for DSM-IV (SCID 1). Biometric Research Department, New York State Psychiatric Institute, New YorkGoogle Scholar
  14. 14.
    Goldberg D, Huxley P. (1980) Mental Illness in the Community: The Pathway to Psychiatric Care. Tavistock Publications. London, UK Google Scholar
  15. 15.
    Greenberg WM, Rosenfeld D, Ortega E. (1995) Adjustment disorder as an admission diagnosis. Am. J. Psych. 152:459-461Google Scholar
  16. 16.
    Hameed U, Schwartz TL, Malhotra K et al. (2005) Antidepressant treatment in the primary care office: outcomes for adjustment disorders versus major depression. Ann. Clin. Psych. 17:77-81Google Scholar
  17. 17.
    Haw C, Hawton K, Houston K, Townsend K. (2001) Psychiatric and personality disorders in deliberate self-harm patients. Br. J. Psych. 178:48-54Google Scholar
  18. 18.
    Jenkins R, Lewis G, Bebbington P et al. (1997) The National Psychiatric Morbidity Survey of Great Britain: initial findings from the Household Survey. Psychol. Med. 27:775-789 Google Scholar
  19. 19.
    Jones R, Yates WR, Zhou MH (2001) Readmission rates for adjustment disorders, comparison with other mood disorders. J. Affect. Disord. 71:199-203Google Scholar
  20. 20.
    Kessler RC, McGonagle KA, Zhao S et al. (1994) Lifetime and 12-month prevalence of DSM-111 R psychiatric disorders in the United States: results from the National Comorbidity Survey. Arch. Gen. Psych. 51: 8-19Google Scholar
  21. 21.
    Koran LM, Sheline Y, Imai K et al. (2003) Medical disorders among patients admitted to a public sector psychiatric in-patient unit. Psychiatr. Serv. 53:1623-1625Google Scholar
  22. 22.
    Lewis G, Pelosi AJ, Araya R et al. (1992) Measuring psychiatric disorders in the community, a standardised assessment for use by lay interviewers. Psychol. Med. 22:465-486Google Scholar
  23. 23.
    Looney JG, Gunderson EKE (1978) Transient situational disturbances: course and outcome. Am. J. Psych. 135:660-663Google Scholar
  24. 24.
    Myers JK, Weissman MM, Dischler GL et al. (1984) Six-month prevalence of psychiatric disorders in three communities 1980 to 1982. Arch. Gen. Psych. 41: 959-967Google Scholar
  25. 25.
    Okamura, H, Watanabe T, Narabayashi M. et al. (2000) Psychological distress following first recurrence of disease in patients with breast cancer: prevalence and risk factors. Breast Cancer Res. Treat. 61:131-137Google Scholar
  26. 26.
    Parker G (2004) Evaluating treatments for mood disorders: time for the evidence to get real. Aust. NZJ. Psych. 38:408-414Google Scholar
  27. 27.
    Parker G. (2005) Beyond major depression. Psychol. Med. 35:467-47Google Scholar
  28. 28.
    Pelkonen M, Marttunen M, Henriksson M et al. (2005) Suicidality in adjustment disorder, clinical characteristics of adolescent outpatients. Eur. Child Adolesc. Psych. 14:174-180Google Scholar
  29. 29.
    Polyakova I, Knobler HY, Ambrumova A Lerner V (1998) Characteristics of suicidal attempts in major depression versus adjustment reactions. J. Affect. Disord. 47:159-167Google Scholar
  30. 30.
    Regier DA, Kaelber CT, Rae DS et al. (1998) Limitations of diagnostic criteria and assessment instruments for mental disorders: implications for research policy. Arch. Gen. Psych. 55:109-115Google Scholar
  31. 31.
    Robins LN, Wing J, Wittchen HU et al. (1988) The Composite International Diagnostic Interview, an epidemiological instrument suitable for use in conjunction with different diagnostic systems and in different cultures. Arch. Gen. Psych. 45:1069-1077Google Scholar
  32. 32.
    Schnyder U Valach L (1997) Suicide attempts in a psychiatric emergency room population. Gen. Hosp. Psych. 19:119-129Google Scholar
  33. 33.
    Sheehan D, Lecrubier Y, Sheehan KH et al. (1998) The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J. Clin. Psych. 59(Suppl 20):22-33Google Scholar
  34. 34.
    Silverstone PH (1996) Prevalence of psychiatric disorders in medical in-patients. J. Nerv. Ment. Dis. 184:43-51Google Scholar
  35. 35.
    Snyder S, Strain JJ, Wolf D (1990) Differentiating major depression from adjustment disorder with depressed mood in a medical setting. Gen. Hosp. Psych. 12:159-165Google Scholar
  36. 36.
    Strain JJ, Smith GC, Hammer JS et al. (1998) Adjustment disorder: a multi-site study of its utilization in the consultation setting. Gen. Hosp. Psych. 20:139-149Google Scholar
  37. 37.
    Van der Klink JJ, van Dijk (2003) Dutch practice guidelines for managing adjustment disorders in occupational and primary health care. Scand. J. Work Environ. Health 29:478-489Google Scholar
  38. 38.
    Wakefield J (1997) Diagnosing DSM-IV-part 1: DSM-IV and the concept of disorder. Behav. Res. Ther. 35:633-649Google Scholar
  39. 39.
    World Health Organisation (1992) The ICD-10 classification of mental and behavioural disorders: clinical description and diagnostic guidelines (ICD-10). WHO, Geneva, SwitzerlandGoogle Scholar
  40. 40.
    World Health Organisation (WHO) (1994) Schedule for Clinical Assessment in Neuropsychiatry. Version 2.1, WHO, Geneva, Switzerland. Google Scholar

Copyright information

© Steinkopff-Verlag 2008

Authors and Affiliations

  1. 1.Matermisericordiae University HospitalUniversity College DublinDublin 7Ireland
  2. 2.Abt. für Psychiatrie, Psychotherapie und PsychosomatikEv. Krankenhaus Königin Elisabeth HerzbergeBerlinDeutschland

Personalised recommendations