Diagnosis of adjustment disorder: reliability of its clinical use and long-term stability.
BACKGROUND
Adjustment disorder is a common diagnosis in mental health services. However, the diagnostic reliability and stability of this nosological construct are unclear.


METHODS
Clinical chart records of patients who had been discharged with a clinical diagnosis of adjustment disorder were re-evaluated by two independent raters using ICD-10 criteria. On the basis of the chart material, the frequency of readmissions and diagnostic changes were recorded.


RESULTS
Of 142 patients with a clinical diagnosis of adjustment disorder, only 91 (64.1%) retrospectively met ICD-10 criteria for this diagnosis. Eighteen of these 91 patients (19.8%) were readmitted to a mental health hospital within a 5-year period and 9 (9.9%) showed a diagnostic change at readmission, 5 of them to substance use disorders (5.5%).


CONCLUSIONS
The dramatic divergence between the clinical diagnosis and ICD-10 criteria challenges the validity and usefulness of the current nosological concept of adjustment disorder.
Department of Psychiatry II, Ulm University, Günzburg, Germany. Markus.Jaeger@bkh-guenzburg.de
Markus
M
Jäger
Daniel
D
Burger
Thomas
T
Becker
Karel
K
Frasch
D000275:Adjustment Disorders / Q000175:diagnosis*; D000328:Adult; D003951:Diagnostic Errors; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006778:Hospitals, Psychiatric; D006801:Humans; D038801:International Classification of Diseases; D008137:Longitudinal Studies; D011594:Psychometrics; D015203:Reproducibility of Results; D012189:Retrospective Studies; D019966:Substance-Related Disorders / Q000175:diagnosis*