[Analysis of the causes and determinants of reaction to severe stress and adjustment disorder patients on mental health clinics].
In everyday life there are many obstacles that prevent the creation of many important needs. They require a skillful adaptation and may be the cause of stress. Stress of considerable intensity can receive the joy of life and even lead to a temporary mental disorder.


OBJECTIVE
To present the main causes and frequency of disturbance determined according to the ICD-10 as a reaction to severe stress and adaptive disorders among patients in psychiatric and psychological counseling and to establish whether the causes of the disorder are dependent on factors such as age, sex or level of education.


METHODS
Analysis was done on a separate group of 754 persons from among patients seeking psychiatric counseling--Psychological Outpatient Mental Health in the 10th Military Clinical Hospital in Bydgoszcz, in 2005. This group were qualified person, who according to the criteria of ICD-10 were found to respond to severe stress and abnormal adaptation. In addition, during the interview determines whether they are long-term somatic illness. They have not been included in the study group. Also excluded persons who were found difficulties in operation prior to the stressful situation and those that have already been treated with psychiatric or psychological benefit from therapy. The collected data were statistically analyzed.


RESULTS
The analysis identifies three main causes of adjustment disorder. The first group of reasons is related to difficulties in the workplace, which represents 59% of all patients with the disorder described. In this group identifies three major stressful situations: bullying, job loss, unemployment. Another reason relates to family problems. They are the reason for the emergence of abnormalities in 23% of patients analyzed group. Among these difficulties was divided into four main types of situation causing disorder presented. There are family conflicts, death of spouse, parent death, divorce. The last group of factors are stressful events or incidents which contributed to the disorder in 16% of patients in the group described. In this category were observed four major groups analyzed the causes of the disorder. This is due to the difficulty of adapting to the compulsory military service, traffic accidents, participation in missions abroad, the situation of rape. Making a detailed analysis by category of difficulty is shown that in this group of subjects, age, educational level and gender are significant factors in influencing the formation of these disorders.


CONCLUSIONS
The main causes of this disorder are closely related to everyday human activity and especially on employment. Harassment and bad relationships in the workplace, job loss, unemployment are the factors most often causing disorder in question. The analysis made also clear that the situations of family conflict is also a frequent cause of severe reactions to stress and adjustment disorder. Not without significance is the impact of factors such as level of education, age and sex. Analysis by specific categories of causes of reactions to stress and adjustment disorder indicates that these factors significantly correlate with the formation of these disorders in the group of people.
Golinowska
Danuta
D
10 Wojskowy Szpital Kliniczny z Poliklinika w Bydgoszczy, Poradnia Zdrowia Psychicznego. danuta2010@poczta.onet.pl
Florkowski
Antoni
A
Juszczak
Dariusz
D
D000275:Adjustment Disorders / Q000453:epidemiology*; D000328:Adult; D015984:Causality; D003376:Counseling / Q000706:statistics & numerical data*; D004522:Educational Status; D004651:Employment / Q000145:classification; D005260:Female; D006772:Hospitals, Military / Q000706:statistics & numerical data; D006801:Humans; D008016:Life Change Events; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008889:Military Personnel / Q000706:statistics & numerical data; D009784:Occupational Diseases / Q000453:epidemiology*; D011044:Poland / Q000453:epidemiology; D012307:Risk Factors; D013315:Stress, Psychological / Q000453:epidemiology*