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A descriptive study of adjustment disorder diagnoses in general hospital patients

Published online by Cambridge University Press:  13 June 2014

Paul Foster
Affiliation:
Parkside Clinic, 63-65 Lancaster Road, London, Wl 1 IQG, England
Thomas Oxman
Affiliation:
Dartmouth Medical School, 1 Medical Centre Drive, Lebanon, NH 03756-001, USA

Abstract

Objective: A descriptive survey of the characteristics of medical and surgical patients given the diagnosis of adjustment disorder.

Method: 124 case notes of patients with adjustment disorder diagnoses seen over a one year period in a tertiary care hospital were reviewed to describe their characteristics. Patient demographic data, medical illness, hospitalisation details and psychiatric consultation notes were examined.

Results: This diagnosis represented 18.5% of consultation-liaison referrals. The length of hospitalisation for the adjustment disorder patients was more than twice that of general medical admissions. At least one psychosocial stressor was noted in 93% of all patients; in 59% of patients the medical illness was one of the stressors noted. About a third of patients had a past psychiatric history. Only 9% of patients had new courses of antidepressants recommended and in only 2% was inpatient psychiatric admission required. The diagnosis was used especially in patients with serious medical conditions, self-harm, injury and poisoning, and in cases presenting with a mixture of somatic and psychic symptoms.

Conclusions: The results suggest that this is a commonly used diagnosis in the medical consultation setting; it is largely being used in a way consistent with DSM criteria, whilst there were indications that it was also used for a range of problem behaviours that are difficult to classify.

Type
Original Papers
Copyright
Copyright © Cambridge University Press 1994

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