title: A Longitudinal Study of Adjustment Disorder After Trauma Exposure.
abstract: OBJECTIVE
  Adjustment disorder has been recategorized as a trauma- and stressor-related disorder in DSM-5. The aim of this study was to determine the prevalence of adjustment disorder in the first 12 months after severe injury; to determine whether adjustment disorder was a less severe disorder compared with other disorders in terms of disability and quality of life; to investigate the trajectory of adjustment disorder; and to examine whether the subtypes described in DSM-5 are distinguishable.
  
  
  METHODS
  In a multisite, cohort study, injury patients were assessed during hospitalization and at 3 and 12 months postinjury (N=826). Structured clinical interviews were used to assess affective, anxiety, and substance use disorders, and self-report measures of disability, anxiety, depression, and quality of life were administered.
  
  
  RESULTS
  The prevalence of adjustment disorder was 19% at 3 months and 16% at 12 months. Participants with adjustment disorder reported worse outcomes relative to those with no psychiatric diagnosis but better outcomes compared with those diagnosed with other psychiatric disorders. Participants with adjustment disorder at 3 months postinjury were significantly more likely to meet criteria for a psychiatric disorder at 12 months (odds ratio=2.67, 95% CI=1.59-4.49). Latent-profile analysis identified a three-class model that was based on symptom severity, not the subtypes identified by DSM-5.
  
  
  CONCLUSIONS
  Recategorization of adjustment disorder into the trauma- and stressor-related disorders is supported by this study. However, further description of the phenomenology of the disorder is required.
authors: From the Phoenix Australia Centre for Posttraumatic Mental Health, Carlton, Victoria, Australia; the Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia; the School of Psychology, University of New South Wales, Sydney, New South Wales, Australia; the School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia; the Centre for Traumatic Stress, University of Adelaide, Adelaide South Australia, Australia; the Mental Health Centre, Psychiatry Research and Teaching Unit, Liverpool, New South Wales, Australia; the School of Psychology, University of Tasmania, Tasmania, Australia; and St. John of God Health Care, Richmond Hospital, North Richmond, Australia.
authors: Meaghan L
authors: ML
authors: O'Donnell
authors: From the Phoenix Australia Centre for Posttraumatic Mental Health, Carlton, Victoria, Australia; the Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia; the School of Psychology, University of New South Wales, Sydney, New South Wales, Australia; the School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia; the Centre for Traumatic Stress, University of Adelaide, Adelaide South Australia, Australia; the Mental Health Centre, Psychiatry Research and Teaching Unit, Liverpool, New South Wales, Australia; the School of Psychology, University of Tasmania, Tasmania, Australia; and St. John of God Health Care, Richmond Hospital, North Richmond, Australia.
authors: Nathan
authors: N
authors: Alkemade
authors: From the Phoenix Australia Centre for Posttraumatic Mental Health, Carlton, Victoria, Australia; the Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia; the School of Psychology, University of New South Wales, Sydney, New South Wales, Australia; the School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia; the Centre for Traumatic Stress, University of Adelaide, Adelaide South Australia, Australia; the Mental Health Centre, Psychiatry Research and Teaching Unit, Liverpool, New South Wales, Australia; the School of Psychology, University of Tasmania, Tasmania, Australia; and St. John of God Health Care, Richmond Hospital, North Richmond, Australia.
authors: Mark
authors: M
authors: Creamer
authors: From the Phoenix Australia Centre for Posttraumatic Mental Health, Carlton, Victoria, Australia; the Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia; the School of Psychology, University of New South Wales, Sydney, New South Wales, Australia; the School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia; the Centre for Traumatic Stress, University of Adelaide, Adelaide South Australia, Australia; the Mental Health Centre, Psychiatry Research and Teaching Unit, Liverpool, New South Wales, Australia; the School of Psychology, University of Tasmania, Tasmania, Australia; and St. John of God Health Care, Richmond Hospital, North Richmond, Australia.
authors: Alexander C
authors: AC
authors: McFarlane
authors: From the Phoenix Australia Centre for Posttraumatic Mental Health, Carlton, Victoria, Australia; the Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia; the School of Psychology, University of New South Wales, Sydney, New South Wales, Australia; the School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia; the Centre for Traumatic Stress, University of Adelaide, Adelaide South Australia, Australia; the Mental Health Centre, Psychiatry Research and Teaching Unit, Liverpool, New South Wales, Australia; the School of Psychology, University of Tasmania, Tasmania, Australia; and St. John of God Health Care, Richmond Hospital, North Richmond, Australia.
authors: Derrick
authors: D
authors: Silove
authors: From the Phoenix Australia Centre for Posttraumatic Mental Health, Carlton, Victoria, Australia; the Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia; the School of Psychology, University of New South Wales, Sydney, New South Wales, Australia; the School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia; the Centre for Traumatic Stress, University of Adelaide, Adelaide South Australia, Australia; the Mental Health Centre, Psychiatry Research and Teaching Unit, Liverpool, New South Wales, Australia; the School of Psychology, University of Tasmania, Tasmania, Australia; and St. John of God Health Care, Richmond Hospital, North Richmond, Australia.
authors: Richard A
authors: RA
authors: Bryant
authors: From the Phoenix Australia Centre for Posttraumatic Mental Health, Carlton, Victoria, Australia; the Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia; the School of Psychology, University of New South Wales, Sydney, New South Wales, Australia; the School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia; the Centre for Traumatic Stress, University of Adelaide, Adelaide South Australia, Australia; the Mental Health Centre, Psychiatry Research and Teaching Unit, Liverpool, New South Wales, Australia; the School of Psychology, University of Tasmania, Tasmania, Australia; and St. John of God Health Care, Richmond Hospital, North Richmond, Australia.
authors: Kim
authors: K
authors: Felmingham
authors: From the Phoenix Australia Centre for Posttraumatic Mental Health, Carlton, Victoria, Australia; the Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia; the School of Psychology, University of New South Wales, Sydney, New South Wales, Australia; the School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia; the Centre for Traumatic Stress, University of Adelaide, Adelaide South Australia, Australia; the Mental Health Centre, Psychiatry Research and Teaching Unit, Liverpool, New South Wales, Australia; the School of Psychology, University of Tasmania, Tasmania, Australia; and St. John of God Health Care, Richmond Hospital, North Richmond, Australia.
authors: Zachery
authors: Z
authors: Steel
authors: From the Phoenix Australia Centre for Posttraumatic Mental Health, Carlton, Victoria, Australia; the Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia; the School of Psychology, University of New South Wales, Sydney, New South Wales, Australia; the School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia; the Centre for Traumatic Stress, University of Adelaide, Adelaide South Australia, Australia; the Mental Health Centre, Psychiatry Research and Teaching Unit, Liverpool, New South Wales, Australia; the School of Psychology, University of Tasmania, Tasmania, Australia; and St. John of God Health Care, Richmond Hospital, North Richmond, Australia.
authors: David
authors: D
authors: Forbes
mesh_terms: D000275:Adjustment Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D000328:Adult; D001315:Australia / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D014947:Wounds and Injuries / Q000453:epidemiology / Q000523:psychology*; D055815:Young Adult
keywords: Other Disorders; Stress