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Adjustment Disorder: A Multisite Study of its Utilization and Interventions in the Consultation-Liaison Psychiatry Setting
Abstract
The consultation-liaison (C-L) psychiatry services of seven university teaching hospitals in the United States, Canada, and Australia (the MICRO-CARES Consortium) used a common clinical database to examine 1039 consecutive referrals. A diagnosis of adjustment disorder (AD) was made in 125 patients (12.0%); as the sole diagnosis, in 81 (7.8%); and comorbidly with other Axis I and II diagnoses in 44 (4.2%). It had been considered as a rule-out diagnosis in a further 110 (10.6%). AD with depressed mood, anxious mood, or mixed emotions were the commonest subcategories used. AD was diagnosed comorbidly most frequently with personality disorder and organic mental disorder. Sixty-seven patients (6.4%) were assigned a V code diagnosis only. Patients with AD were referred significantly more often for problems of anxiety, coping, and depression; had less past psychiatric illness; and were rated as functioning better--all consistent with the construct of AD as a maladaptation to a psychosocial stressor. Interventions were similar to those for other Axis I and II diagnoses, in particular, the prescription of antidepressants. Patients with AD required a similar amount of clinical time and resident supervision. It is concluded that AD is an important and time-consuming diagnostic category in C-L psychiatry practice.
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“Prevalence rates for adjustment disorders range from 7.1 % in patients with breast cancer [8] to 12 % in a consultation-liaison psychiatry service [9] and to 17 % in patients with cardiovascular diseases [10].”
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Metadata
- Authors
- Strain, J.
- Affiliations
- Mount Sinai Hospital (US)
- Corresponding author
- Strain, J
- ORCID
- Strain, J
- Venue
- General Hospital Psychiatry
- Publisher
- Elsevier BV
- Published
- 1998-05
- Volume
- 20
- Issue
- 3
- Pages
- 139-149
- ISSN
- 0163-8343 (ISSN-L)
- OpenAlex
- W1978541970
- Cited by
- 180
- References
- 27
- Citations by year
- 2026: 1 · 2025: 8 · 2024: 5 · 2023: 3 · 2022: 11 · 2021: 3 · 2020: 4 · 2019: 6 · 2018: 10 · 2017: 8 · 2016: 4 · 2015: 7 · 2014: 5 · 2013: 11 · 2012: 15
- FWCI
- 2.74
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- General Hospital Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- adjustment disorder, psychosomatic medicine, hospital psychiatric services, diagnostic patterns, comorbidities, antidepressant prescribing, psychosocial stressors, clinical utilization, resident supervision
- MeSH terms
- Adjustment Disorders, Adult, Aged, Australia, Canada, Demography, Diagnosis, Differential, Factor Analysis, Statistical, Female, Humans, Male, Middle Aged, Personality Disorders, Psychiatric Status Rating Scales, Referral and Consultation, Stress, Psychological, United States, Cohort Studies, Comorbidity, Chi-Square Distribution, Age Distribution, Sex Distribution, Neurocognitive Disorders, Substance-Related Disorders
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