Hostname: page-component-848d4c4894-m9kch Total loading time: 0 Render date: 2024-06-01T13:57:06.528Z Has data issue: false hasContentIssue false
  • English
  • Français

Adolescent adjustment disorder: Precipitant stressors and distress symptoms of 89 outpatients

Published online by Cambridge University Press:  16 April 2020

Mirjami Pelkonen ,
Mauri Marttunen ,
Markus Henriksson  and
Jouko Lönnqvist
Mirjami Pelkonen*
Affiliation:
National Public Health Institute, Department of Mental Health and Alcohol Research, Helsinki, Finland Department of Social Psychiatry, University of Tampere, Tampere School of Public Health, Tampere, Finland
Mauri Marttunen
Affiliation:
Department of Adolescent Psychiatry, Peijas Hospital, Helsinki University Hospital, Vantaa, Finland University of Oulu, Department of Psychiatry, Oulu, Finland
Markus Henriksson
Affiliation:
Centre for Military Medicine, Finnish Defence Forces, Lahti, Finland
Jouko Lönnqvist
Affiliation:
Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland
*
*Corresponding author. Department of Mental Health and Alcohol Research, National Public Health Institute, Mannerheimintie 166, FIN-00300 Helsinki, Finland. Tel.: +358 9 47448213; fax: +358 9 47448478. E-mail addresses: mirjami.pelkonen@ktl.fi (M. Pelkonen), mauri. marttunen@ktl.fi (M. Marttunen), markus.henriksson@mil.fi (M. Henriksson), jouko.lonnqvist@ktl.fi (J. Lönnqvist).
Get access

Abstract

Objective

Research on adolescent adjustment disorder (AD) is scarce. We characterized adolescent outpatients with AD in psychosocial background and treatment received compared with patients with other non-psychotic disorders (OND). Furthermore, we explored precipitant stressors, distress symptoms and behavioral problems among males and females with AD.

Method

Data were collected prospectively on 290 consecutive psychiatric outpatients, aged 12–22 yrs, at a secondary care clinic in Finland. DSM-III-R diagnoses were assigned, based on all available information, at the end of treatment.

Results

AD was the second most common diagnosis among non-psychotic patients (31% of 290). Compared to OND-patients, those with AD were predominantly female and had less severe psychosocial impairment. In multivariate comparisons school-related stressors, problems with law and restlessness characterized males, and parental illness and internalizing symptoms females with AD. Intensity and duration of treatment of AD-patients varied widely.

Conclusions

Adjustment disorder comprised a common clinical entity among adolescent outpatients. Psychiatric assessment and treatment should be individually targeted by taking into account gender-specific stressors and distress symptoms among young people with AD.

Keywords

AdolescenceAdjustment disorderPsychiatric treatmentPrecipitant stressorsDistress symptoms
Type
Original article
Information
European Psychiatry , Volume 22 , Issue 5 , July 2007 , pp. 288 - 295
Copyright
Copyright © Elsevier Masson SAS 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aalto-Setälä, T., Marttunen, M., Tuulio-Henriksson, A., Poikolainen, K., Lönnqvist, J.Depressive symptoms in adolescence as predictors of early adulthood depressive disorders and maladjustment. Am J Psychiatry 2002;159:1235–1237.CrossRefGoogle ScholarPubMed
Al-Ansari, A., Matar, A.M.Recent stressful life events among Bahraini adolescents with adjustment disorder. Adolescence 1993;28:339–346.Google ScholarPubMed
American Psychiatric Association Diagnostic and statistical manual of mental disorders. 3rd ed.Washington, DC: APA; 1987. rev (DSM-III-R).Google Scholar
American Psychiatric Association Diagnostic and statistical manual of mental disorders. 4th ed.Washington, DC: APA; 1994. DSM-IV.Google Scholar
Andreasen, N.C., Wasek, P.Adjustment disorders in adolescents and adults. Arch Gen Psychiatry 1980;37:1166–1170.CrossRefGoogle ScholarPubMed
Andreasen, N.C., Hoenk, P.R.The predictive value of adjustment disorders: a follow-up study. Am J Psychiatry 1982;139:584–590.Google ScholarPubMed
Casey, P., Dowrick, C., Wilkinson, G.Adjustment disorders. Fault line in the psychiatric glossary. Br J Psychiatry 2001;179:479–481.CrossRefGoogle ScholarPubMed
Central Statistical Office of Finland Classification of occupations. Helsinki: Central Statistical Office of Finland; 1987.Google Scholar
Chorpita, B.F., Barlow, D.H.The development of anxiety: the role of control in the early environment. Psychol Bull 1998;124:3–21.CrossRefGoogle ScholarPubMed
Despland, J.N., Monod, L., Ferrero, F.Clinical relevance of adjustment disorder in DSM-III-R and DSM-IV. Compr Psychiatry 1995;36:454–460.CrossRefGoogle ScholarPubMed
Endicott, J., Spitzer, R.L., Fleiss, J.L., Cohen, J.The global assessment scale. Arch Gen Psychiatry 1976;33:766–771.CrossRefGoogle ScholarPubMed
Fabrega, H., Mezzich, J.E., Mezzich, A.C.Adjustment disorder as a marginal or transitional illness category in DSM-III. Arch Gen Psychiatry 1987;44:567–572.CrossRefGoogle ScholarPubMed
Faulstich, M.E., Moore, J.R., Carey, M.P., Ruggiero, L., Gresham, F.Prevalence of DSM-III conduct and adjustment disorders for adolescent psychiatric inpatients. Adolescence 1986;21:333–336.Google ScholarPubMed
Fergusson, D.M., Horwood, L.J., Lynskey, M.T.Parental separation, adolescent psychopathology, and problem behaviors. J Am Acad Child Adolesc Psychiatry 1994;33:1122–1131.CrossRefGoogle ScholarPubMed
Forehand, R., Biggar, H., Kotchick, B.A.Cumulative risk across family stressors: short- and long-term effect for adolescents. J Abnorm Child Psychol 1998;26:119–128.CrossRefGoogle Scholar
Ge, X., Conger, R.D.Adjustment problems and emerging personality characteristics from early to late adolescence. Am J Community Psychol 1999;27:429–459.CrossRefGoogle ScholarPubMed
Giotakos, O.Parenting received in childhood and early separation anxiety in male conscripts with adjustment disorder. Mil Med 2002;167:28–33.CrossRefGoogle ScholarPubMed
Gonzalez-Jaimes, E.I., Turnbull-Plaza, B.Selection of psychotherapeutic treatment for adjustment disorder with depressive mood due to acute myocardial infarction. Arch Med Res 2003;34:298–304.CrossRefGoogle ScholarPubMed
Greenberg, W.M., Rosenfeld, D.N., Ortega, E.A.Adjustment disorder as an admission diagnosis. Am J Psychiatry 1995;152:459–461.Google ScholarPubMed
Katzman, J.W., Tomori, O.Adjustment disorders. In: Sadock, B.J., Sadock, V.A., editor. Comprehensive textbook of psychiatry 8th ed.Philadelphia: Lippincott William & Wilkins; 2005. p. 2055–2062.Google Scholar
Kim, K.J., Conger, R.D., Elder, G.H. Jr., Lorenz, F.O.Reciprocal influences between stressful life events and adolescent internalizing and externalizing problems. Child Dev 2003;74:127–143.CrossRefGoogle ScholarPubMed
Kovacs, M., Gatsonis, C., Pollock, M., Parrone, P.L.A controlled prospective study of DSM-III adjustment disorder in childhood. Arch Gen Psychiatry 1994;51:535–541.CrossRefGoogle ScholarPubMed
Kovacs, M., Ho, V., Pollock, M.H.Criterion and predictive validity of the diagnosis of adjustment disorder: a prospective study of youths with new-onset insulin-dependent diabetes mellitus. Am J Psychiatry 1995;152:523–528.Google Scholar
Lönnqvist, J.Evaluation of psychiatric treatment. Psychiatria Fennica 1984;15:29–40.Google Scholar
Marttunen, M.J., Aro, H.M., Henriksson, M.M., Lönnqvist, J.Adolescent suicides with adjustment disorders or no psychiatric diagnosis. Eur Child Adolesc Psychiatry 1994;3:101–110.CrossRefGoogle ScholarPubMed
Newcorn, J., Strain, J.Adjustment disorder in children and adolescents. J Am Acad Child Adolesc Psychiatry 1992;31:318–327.CrossRefGoogle ScholarPubMed
Newcorn, J.H., Strain, J.Adjustment disorder in children and adolescents. In: Widiger, T.A., Frances, A.J., Pincus, H.A., Ross, R., First, M.B., Davis, W., editors. DSM-IV sourcebook vol. 3 Washington, DC: APA; 1997. p. 291–301.Google Scholar
Pelkonen, M., Marttunen, M., Pulkkinen, E., Laippala, P., Aro, H.Characteristics of outpatient adolescents with suicidal tendencies. Acta Psychiatr Scand 1997;95:100–107.CrossRefGoogle ScholarPubMed
Pelkonen, M., Marttunen, M., Laippala, P., Lönnqvist, J., Aro, H.Psychosocial functioning in adolescent psychiatric patients: a prospective study on the changes in psychosocial functioning among severely and moderately impaired adolescent outpatients. Acta Psychiatr Scand 1997;96:217–224.CrossRefGoogle Scholar
Pelkonen, M., Marttunen, M., Laippala, P., Lönnqvist, J.Factors associated with early dropout from adolescent psychiatric outpatient treatment. J Am Acad Child Adolesc Psychiatry 2000;39:329–336.CrossRefGoogle ScholarPubMed
Pelkonen, M., Marttunen, M., Aro, H.Risk for depression: a 6-year follow-up of Finnish adolescents. J Affect Disord 2003;77:41–51.CrossRefGoogle ScholarPubMed
Pelkonen, M., Marttunen, M., Henriksson, M., Lönnqvist, J.Suicidality in adjustment disorder. Clinical characteristics of adolescent outpatients. Eur Child Adolesc Psychiatry 2005;14:174–180.CrossRefGoogle ScholarPubMed
Pichel, J.I.A long-term follow-up study of 60 adolescent psychiatric outpatients. Am J Psychiatry 1974;131:140–144.CrossRefGoogle ScholarPubMed
Snyder, S., Strain, J.J., Wolf, D.Differentiating major depression from adjustment disorder with depressed mood in the medical setting. Gen Hosp Psychiatry 1990;12:159–165.CrossRefGoogle ScholarPubMed
Spalletta, G., Troisi, A., Saracco, M., Ciani, N., Pasini, A.Symptom profile, axis II comorbidity and suicidal behavior in young males with DSM-III-R depressive illnesses. J Affect Disord 1996;39:141–148.CrossRefGoogle ScholarPubMed
SPSS, Inc. SPSS base 12.0 for Windows: user's guide. Chicago: SPSS, Inc.; 2003.Google Scholar
Strain, J.J., Newcorn, J., Wolf, D., Fulop, G., Davis, W.Considering changes in adjustment disorder. Hosp Community Psychiatry 1993;44:13–15.Google ScholarPubMed
Strain, J.J., Newcorn, J., Mezzich, J., Kirisci, L.Adjustment disorder: the MacArthur reanalysis. In: Widiger, T.A., Frances, A.J., Pincus, H.A., Ross, R., First, M.B., Davis, W., editors. DSM-IV sourcebook vol. 4 Washington, DC: APA; 1998. p. 403–424.Google Scholar
van der Klink, J.J.L., van Dijk, F.J.H.Dutch practice guidelines for managing adjustment disorders in occupational and primary health care. Scand J Work Environ Health 2003;29:478–487.CrossRefGoogle ScholarPubMed
Woolston, J.L.Theoretical considerations of the adjustment disorders. J Am Acad Child Adolesc Psychiatry 1988;27:280–287.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.