Adjustment Disorders

    Adjustment Disorders

    The newest guide to diagnosing mental disorders is the DSM-5, classifies Adjustment Disorders as Stressor-related disorders which are caused by a specific stressor. [2]

    Adjustment Disorders DSM-5 Diagnostic Criteria
    Code 309
    • "A. The development of emotional or behavioral symptoms in response to an identifiable stressor(s) occurring within 3 months of the onset of the stressor(s).
    • B. These symptoms or behaviors are clinically significant, as evidenced by one or both of the following:
      • Marked distress that is out of proportion to the severity or intensity of the stressor, taking into account the external context and the cultural factors that might influence symptom severity and presentation.
      • Significant impairment in social, occupational, or other important areas of functioning.
    • C. The stress-related disturbance does not meet the criteria for another mental disorder and is not merely an exacerbation of a preexisting mental disorder.
    • D. The symptoms do not represent normal bereavement.
    • E. Once the stressor or its consequences have terminated, the symptoms do not persist for more than an additional 6 months." [2]:151-152

    Specify whether:

    • Acute, Persistent (Chronic)

    Specify whether:

    • 309.0 F43.21 With depressed mood: Low mood, tearfulness, or feelings of hopelessness are predominant.
    • 309.24 F43.22 With anxiety: Nervousness, worry, jitteriness, or separation anxiety is predominant.
    • 309.28 F43.23 With mixed anxiety and depressed mood: A combination of depression and anxiety is predominant.
    • 309.3 F43.24 With disturbance of conduct: Disturbance of conductis predominant.
    • 309.4 F43.25 With mixed disturbance or emotions and conduct: Both emotional symptoms (e.g., depression and anxiety) and a disturbance of conduct are predominant.
    • 309.9 F43.20 Unspecified For maladapative reactions that are not classifiable as one of the specified subtypes of adjustment disorder. [2]:151-152
    ICD Diagnostic Criteria

    The most recent approved version of the International Classification of Diseases, the diagnostic guide published by the World Health Organization is the ICD-10, published in 1992.[2] The draft ICD-11 criteria for Adjustment Disorders gives this description:

    ICD 11 draft - Adjustment Disorder
    Code 7B23

    "Adjustment disorder is a maladaptive reaction to identifiable psychosocial stressor(s) or life change(s) characterized by preoccupation with the stressor and failure to adapt. The failure to adapt may be manifested by a range of symptoms that interfere with everyday functioning, such as difficulties concentrating or sleep disturbance. Symptoms of anxiety, depression, and impulse control or conduct problems are commonly present and may be the presenting feature. The symptoms emerge within a month of the onset of the stressor(s) and tend to resolve in 6 months unless the stressor persists for a longer duration. In order to be diagnosed, Adjustment disorder must be associated with significant distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning." [3] Last updated December 2014.

    Alternative names include culture shock, grief reaction, and hospitalism in children. Excludes separation anxiety disorder of childhood. [3]

    ICD 10 Diagnostic Criteria
    Code F43.2

    "States of subjective distress and emotional disturbance, usually interfering with social functioning and performance, arising in the period of adaptation to a significant life change or a stressful life event. The stressor may have affected the integrity of an individual's social network (bereavement, separation experiences) or the wider system of social supports and values (migration, refugee status), or represented a major developmental transition or crisis (going to school, becoming a parent, failure to attain a cherished personal goal, retirement). Individual predisposition or vulnerability plays an important role in the risk of occurrence and the shaping of the manifestations of adjustment disorders, but it is nevertheless assumed that the condition would not have arisen without the stressor. The manifestations vary and include depressed mood, anxiety or worry (or mixture of these), a feeling of inability to cope, plan ahead, or continue in the present situation, as well as some degree of disability in 9the performance of daily routine. Conduct disorders may be an associated feature, particularly in adolescents. The predominant feature may be a brief or prolonged depressive reaction, or a disturbance of other emotions and conduct." [1]

    Alternative names include culture shock, grief reaction, and hospitalism in children. Excludes separation anxiety disorder of childhood. [1]


    Co-occuring disorders are restricted. For example, an Adjustment Disorder cannot be diagnosed if a more specific psychiatric disorder is appropriate, for example major depressive disorder or panic disorder, even if the stressor is the cause of the disorder. [4]:186 Disturbance of conduct may leads to a person acting out, for example a teenager stealing or an adult conducting an extra-marital affair. [4]:188


    1. World Health Organization. (2010) ICD-10 Version: 2010. Retrieved December 7, 2014, from
    2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). Washington, D.C.: American Psychiatric Association. ISBN 0890425558.
    3. World Health Organization. (December 7, 2014). ICD-11 Beta Draft (Joint Linearization for Mortality and Morbidity Statistics).
    4. Black, Donald W. (2014) (coauthors: Grant, Jon E.). DSM-5 Guidebook: The Essential Companion to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. American Psychiatric Pub. ISBN 9781585624652.

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