Outcome for adjustment disorder with depressed mood: comparison with other mood disorders.
BACKGROUND
A review of the research literature on the diagnostic category of adjustment disorder indicates that its construct validity has not been established. Nevertheless, the diagnosis is made frequently, with an estimated incidence of 5-21% in psychiatric consultation services for adults.


METHODS
Retrospective data was used to evaluate the construct validity of the adjustment disorder diagnostic category. The data primarily consisted of SF-36 Health Status Survey responses by a large group of adult psychiatric outpatients before treatment and again six months after beginning treatment. Subjects were divided into five diagnostic groups, and MANOVA, MANCOVA and chi square were used to clarify relationships among diagnoses, sociodemographic data and SF-36 scores.


RESULTS
Diagnostic categories were significantly different at baseline, but did not differ in terms of outcome at six-months follow-up. There was a significant gender difference at baseline and a significant difference in gender distribution across diagnostic categories.


CONCLUSIONS
Structured interviews were not used for initial diagnoses, nor is there an estimate of the reliability of diagnoses among the clinicians. The patient attrition rate for six-months follow-up data was about 50%. Finally, patients received individualized treatment, with some patients receiving both medication and psychotherapy.


CONCLUSIONS
Female patients were significantly more likely to be diagnosed with major depression or dysthymia than with an adjustment disorder. Females were also more likely than males to score lower on the mental health related scales of the SF-36 at admission. Patients diagnosed with an adjustment disorder scored higher on all SF-36 scales than did the other diagnostic groups at baseline and again at follow-up. There was no significant difference among diagnostic groups with regard to treatment outcome, suggesting that the adjustment disorder group can benefit as much as the other groups from treatment.
Jones
R
R
Laureate Psychiatric Research Center, Tulsa, OK 74136, USA. LPRC@saintfrancis.com
Yates
W R
WR
Williams
S
S
Zhou
M
M
Hardman
L
L
D000275:Adjustment Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D003131:Combined Modality Therapy; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D019263:Dysthymic Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010552:Personality Assessment; D011613:Psychotherapy; D012008:Recurrence
D000928:Antidepressive Agents