Adjustment disorder, traumatic stress, depression and anxiety in Poland during an early phase of the COVID-19 pandemic
Open accessAbstract
Background: The current COVID-19 pandemic is associated with a variety of stressors. Preliminary research has demonstrated that general public are experiencing a range of psychological problems, including stress-related disturbances. However, to date, there is not much research on the prevalence of adjustment disorder during the current pandemic.Objectives: This study aimed to assess the prevalence and severity of symptoms of adjustment disorder compared to posttraumatic symptoms, depression and generalized anxiety in a large sample of adult Poles, in the first phase of the current pandemic.Method: Self-report data from a web-based sample (N = 1,742) was collected between March 25 and April 27, just after the introduction of nationwide quarantine measures in Poland.Results: The current COVID-19 pandemic was a highly stressful event for 75% of participants and the strongest predictor of adjustment disorder. Increased symptoms of adjustment disorder were reported by 49%, and they were associated with female gender and not having a full-time job. However, after exclusion of co-occurring symptomatology, 14% of the sample were finally qualified as meeting diagnostic criteria of adjustment disorder. A substantial proportion of the sample screened also positive for generalized anxiety (44%) and depression (26%); the rate for presumptive PTSD diagnosis was 2.4%.Conclusions: High rates of negative mental health outcomes were found in the Polish population in the first weeks into the COVID-19 pandemic and lockdown measures. They indicate the intense current stress-related symptoms in the early phase of the pandemic and warrant further monitoring on population’s mental health.
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The Polish version of the GAD-7 has recently been used in various studies to assess anxiety during the COVID-19 pandemic in Poland.
“The Polish version of the GAD-7 has not been validated yet but has recently been used in various studies to assess anxiety during the COVID-19 pandemic in Poland and shown high internal consistency [59–61].”
The Polish version of the GAD-7 has shown high internal consistency.
“The Polish version of the GAD-7 has not been validated yet but has recently been used in various studies to assess anxiety during the COVID-19 pandemic in Poland and shown high internal consistency [59–61].”
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Factors Affecting Psychological Health in the COVID-19 Pandemic
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“The adequate model fit was considered non-significant in 2 tests and if the following criteria were met (57): RMSEA<0.”
The Transformation of the Global Civil Society during the Covid-19 Pandemic
Duliba, Y., Ovcharuk, S., Doichyk, M. V., Гоян, І., Vergolyas, M. R., & Sarancha, I. (2022) · Postmodern Openings · doi:10.18662/po/13.1/406 · Cited by 5 · see citing works
Embitterment during the COVID-19 Pandemic in Reaction to Injustice, Humiliation, and Breach of Trust
Linden, M., Arnold, C. P., & Muschalla, B. (2022) · Psychiatry International · doi:10.3390/psychiatryint3030016 · Cited by 5 · see citing works
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“Covid-19 distress was assessed by a short but reliable operationalization of this continuous variable based on studies published prior to the commencement of our research (e.g. Dragan et al., 2021).”
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“Recently, the COVID-19 pandemic has emerged as a factor exacerbating adjustment disorders among medical students [9].”
BackgroundHow to Create Healthy, Stress-Resilient Post-Pandemic Cities
Wdowicka, M., Mierzejewska, L., Szejnfeld, M., Modrzewski, B., Sikorska-Podyma, K., Wronkowski, A., & Lechowska, E. (2024) · Sustainability · doi:10.3390/su16093644 · Cited by 4 · see citing works
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“It was also associated with a higher incidence of depression, anxiety, PTSD and sleep problems (post-traumatic stress disorder) (Kumar and Nayar, 2020; Dragan et al., 2021; Li et al., 2021; O'Connor et al., 2021; Fountoulakis et al., 2022; Luo et al., 2022).”
BackgroundLi, C. J., Tao, T. J., Tang, J. C. Y., Bonanno, G. A., & Hou, W. K. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.01.102 · Cited by 4 · see citing works
Dragan, M., Szumiał, S., Grajewski, P., Kluska, J., Przewłoka, P., & Lotzin, A. (2025) · Current Psychology · doi:10.1007/s12144-025-08388-5 · Cited by 3 · see citing works
Self-citationSchetz, D., Scott, T., Waldman, W., Anand, J. S., Wiergowski, M., & Kocić, I. (2023) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2023.114681 · Cited by 3 · see citing works
Humor and fear of COVID-19 in Polish adults: the mediating role of generalized anxiety
Brudek, P. J., & Steuden, S. (2022) · Humor - International Journal of Humor Research · doi:10.1515/humor-2022-0014 · Cited by 3 · see citing works
The impact of the COVID-19 pandemic on the development of anxiety disorders - a literature review
Koch, M., Chmielowiec, K., Grzywacz, E., Suchanecka, A., Masiak, J., & Chmielowiec, J. (2021) · Current Problems of Psychiatry · doi:10.2478/cpp-2021-0024 · Cited by 3 · see citing works
Okada, M., Bando, H., Iwatsuki, N., Sakamoto, K., & Ogawa, T. (2023) · Asploro Journal of Biomedical and Clinical Case Reports · doi:10.36502/2023/asjbccr.6303 · Cited by 3 · see citing works
A DOR NOS TEMPOS DA COVID-19: TRANSTORNO DE ADAPTAÇÃO NOS PROFESSORES DO ENSINO SUPERIOR BRASILEIRO
Nascimento, E. M., Cornacchione, E. B., & Garcia, M. C. (2024) · Educação em Revista · doi:10.1590/0102-469835866 · Cited by 3 · see citing works
Juszczyk-Kalina, A., Holas, P., Bachem, R., & Roczon, P. (2026) · Journal of American College Health · doi:10.1080/07448481.2025.2593313 · Cited by 2 · see citing works
“46 In the current study, good internal consistency was found (α = .87).”
Predictors of pretraumatic stress during the COVID-19 pandemic in Poland
Łyś, A. E., Huflejt-Łukasik, M., Gambin, M., Studzińska, A., Bargiel-Matusiewicz, K. M., Oleksy, T., Wnuk, A., & Pankowski, D. (2023) · PLoS ONE · doi:10.1371/journal.pone.0290151 · Cited by 2 · see citing works
“[10] found that, at the beginning of the pandemic, 75.”
BackgroundYue, R. P. H., & Lau, B. H. P. (2025) · Scientific Reports · doi:10.1038/s41598-025-24311-1 · Cited by 2 · see citing works
“51 , or patients in palliative-care settings (15.4”
InfluentialHolas, P., Juszczyk-Kalina, A., Wardęszkiewicz, J., Ciarrochi, J., & Hayes, S. C. (2025) · Healthcare · doi:10.3390/healthcare13080934 · Cited by 16 · see citing works
“Additionally, 49% reported increased AjD symptoms, with higher prevalence among females and those without full-time employment [16].”
Gunasekaran, S., Tay, E. H., Shafie, S., Shahwan, S., Wang, P., Zhang, Y., Satghare, P., Tan, S. C., Ni, M. Y., Lun, P., et al. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1516829 · Cited by 1 · see citing works
Posttraumatic stress disorder and respiratory illnesses
Chung, M. C. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780198727323.003.0008 · Cited by 1 · see citing works
Entering terra incognita: Adapting Psychotherapists to Work During the COVID-19 Pandemic
Zielona–Jenek, M., Izdebska, A., & Soroko, E. (2022) · The Qualitative Report · doi:10.46743/2160-3715/2023.6036 · Cited by 1 · see citing works
“The number of people struggling with depression, anxiety, traumatic stress, and adjustment disorders increased rapidly (Dragan et al., 2021; Gambin et al., 2021).”
Turk Ornekleminde Koronavirus Korkusu ve Kaygisina Iliskin Sosyodemografik Bir Inceleme
Karaman, G., RKKAN, Z., Yumuşak, F. N., Bahadır, E., Akkuzu, H., & Ladikli, N. (2021) · Klinik Psikoloji Dergisi · doi:10.5455/kpd.26024438m000056
“Considering the financial situation and the information about working continuously, Dragan et al. (2021) reported the positive contributions of working in a permanent job to psychological health.”
BackgroundLa depresión en tiempos de covid-19: análisis del impacto de la pandemia en grupos vulnerables
Tarazona, C. N. L. (2021) · Revista EDUCA UMCH · doi:10.35756/educaumch.202118.178
Kulesza, M., & STAŃCZUK, M. (2022) · Springer eBooks · doi:10.1007/978-3-658-38667-2_12
Impact of the COVID-19 pandemic on the mental health and social functioning of healthcare workers
Belcarz, M., & Marczewska, S. (2023) · Journal of Education Health and Sport · doi:10.12775/jehs.2023.13.04.038
Assessment of adjustment disorder in people with COVID-19 infection
PEKER, Ş., & Topuzoǧlu, A. (2023) · Türkiye Halk Sağlığı Dergisi · doi:10.20518/tjph.1097282
Motherhood during the COVID-19 pandemic in Poland – qualitative studies
Stępień, O., Dębska, M., Klimanek, J., Szlendak, B., Vermeulen, J., & Bączek, G. (2023) · Kwartalnik Naukowy Fides et Ratio · doi:10.34766/fetr.v53i1.1092
Dragan, M., & Grajewski, P. (2023) · Brain Sciences · doi:10.3390/brainsci13081162 · Cited by 15 · see citing works
“The aim of this study is to examine the association between the symptoms of CAS and stress- and trauma-related psychopathology in the context of the COVID-19 pandemic, which is perceived as a highly stressful situation by most people [10], causing multiple stressors, illnesses, deaths, and strain on healthcare and eco…”
BackgroundInfluentialSelf-citationHolas, P., Juszczyk-Kalina, A., Ciarrochi, J., & Hayes, S. C. (2023) · Research Square · doi:10.21203/rs.3.rs-3576580/v1
Mrozowicz-Wrońska, M., Ślosarczyk, K., & Koczurek, M. (2023) · Przegląd Psychologiczny · doi:10.31648/przegldpsychologiczny.9069
Mrozowicz-Wrońska, M., Ślosarczyk, K., & Koczurek, M. (2023) · Przegląd Psychologiczny · doi:10.31648/przegldpsychologiczny.9804
“This was particularly the case for those who had to stay in quarantine after contact with an infected person and those who were found to be infected with the coronavirus (Dragan et al., 2021; Mrozowicz-Wrońska et al., 2021).”
BackgroundRapolienė, L., Šaparnienė, D., Martinkėnas, A., Dailidienė, I., Bredelytė, A., Grigaliūnaitė, G., & Rapolis, D. (2024) · SOCIAL WELFARE INTERDISCIPLINARY APPROACH · doi:10.15388/sw.2024.14.2
A Year in the Life: Living Portraits of the COVID-19 Pandemic in Portugal
Caetano, A. P., Nico, M., Pereira, A., Correia, S. B., & Goodwin, J. D. (2024) · Frontiers in sociology and social research · doi:10.1007/978-3-031-54442-2_2
Hintze, B., Woźniak‐Prus, M., Gawrych, M., & Cudo, A. (2024) · Psychiatria i Psychologia Kliniczna · doi:10.15557/pipk.2024.0004
PAIN IN TIMES OF COVID-19: ADJUSTMENT DISORDER IN BRAZILIAN HIGHER EDUCATION PROFESSORS
Nascimento, E. M., Cornacchione, E. B., & Garcia, M. C. (2024) · Educação em Revista · doi:10.1590/0102-469835866t
Stress – mission possible! The STRESSmission game as a psychoeducational tool in coping with stressPreprint
Archanowicz-Kudelska, K., Sliwowska, J. H., & Bonk, E. (2024) · Research Square · doi:10.21203/rs.3.rs-5269742/v1
THE IMPACT OF COVID-19 INFECTION ON PATIENTS HOSPITALIZED IN PSYCHIATRY HOSPITAL WARDS
Florek, S., Florczyk, I., Malec, A. K., Buszman, K., Sołtys, W., & Gorczyca, P. W. (2023) · Zeszyty Naukowe Wyższej Szkoły Humanitas w Sosnowcu Pedagogika · doi:10.5604/01.3001.0054.4346
Abdalla, S. M., Voss, R. E., Pickerel, M., Rosenberg, S. B., Rasool, A., Abba‐Aji, M., Ettman, C. K., & Galea, S. (2025) · SSM - Mental Health · doi:10.1016/j.ssmmh.2025.100521 · Cited by 1 · see citing works
Roos, R., Witteveen, A. B., Ayuso-Mateos, J. L., Barbui, C., Bryant, R. A., Félez-Nóbrega, M., Figueiredo, N., Kalisch, R., Haro, J. M., McDaid, D., et al. (2024) · Figshare · doi:10.6084/m9.figshare.24494502
Roos, R., Witteveen, A. B., Ayuso-Mateos, J. L., Barbui, C., Bryant, R. A., Félez-Nóbrega, M., Figueiredo, N., Kalisch, R., Haro, J. M., McDaid, D., et al. (2023) · Figshare · doi:10.6084/m9.figshare.24494112
Ferolino, A. J. P., Mordeno, I. G., & Ducay, J. (2026) · Measurement and Evaluation in Counseling and Development · doi:10.1080/07481756.2026.2649584
“This is important given that literature has shown adjustment disorder symptoms were prominent during the pandemic (Ben-Ezra et al., 2021; Dragan et al., 2021; Harris et al., 2023) and after the pandemic (e.g. Brunet et al., 2022; Zrnić Novaković et al., 2023).”
Huflejt-Łukasik, M., Szuster, A., Pastwa, M., Wielgopolan, A., Karwowska, D., Haletska, I., Klimanska, M., & Imbir, K. (2026) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph23050606
“Increased symptoms of adjustment disorders were reported by 49% of individuals [74].”
Wielgus, B., & Cichocki, Ł. (2026) · Psychiatria i Psychologia Kliniczna · doi:10.15557/pipk.2026.0003
Lotzin, A., Finne, E., Schildbach, G., Acquarini, E., Ajduković, D., Ajduković, M., Anastassiou‐Hadjicharalambous, X., Ardino, V., Hensler, I., Arnberg, F. K., et al. (2026) · Psychological Medicine · doi:10.1017/s0033291726104048
“In accordance with preceding cross-sectional research (e.g. Ben-Ezra et al., 2021; Dragan et al., 2021), social factors such as social isolation and restricted personal contact with loved ones were among the variables with the highest importance for predicting AjD symptoms in the present study.”
Self-citationValidation of the International Adjustment Disorder Questionnaire and Adjustment Disorder in Türkiye
Alpay, E. H., & Özçürümez, G. (2026) · Journal of Aggression Maltreatment & Trauma · doi:10.1080/10926771.2026.2718742
“Prior studies have also documented strong associations between adjustment disorder and internalizing disorders such as depression and anxiety (Blázquez & Cruzado, 2016; Dragan et al., 2021; Mitchell et al., 2017).”
Roos, R., Witteveen, A. B., Ayuso‐Mateos, J. L., Barbui, C., Bryant, R. A., Dontsova, Z., Félez-Nóbrega, M., Głowacka, Z., Haro, J. M., Kalisch, R., et al. (2026) · PLoS Medicine · doi:10.1371/journal.pmed.1005197
- Authors
- Dragan, M., Grajewski, P., & Shevlin, M.
- Affiliations
- University of Warsaw (PL)
- University of Ulster (GB)
- Corresponding author
- Dragan, Małgorzata
- Venue
- European Journal of Psychotraumatology
- Publisher
- Informa UK Limited
- Published
- 2021-01
- Volume
- 12
- Issue
- 1
- Pages
- 1860356-1860356
- ISSN
- 2000-8066 (ISSN-L)
- PMC
- PMC8725738
- OpenAlex
- W3123518432
- Cited by
- 93
- References
- 33
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 16 · 2023: 27 · 2022: 23 · 2021: 13
- FWCI
- 13.47
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- European Journal of Psychotraumatology (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Ulster University Research Portal (Ulster University) (submittedVersion, cc-by-nc)
- Funders
- Faculty of Psychology, University of Warsaw (501-D125-01-1250000 zlec.5011000218)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Keywords
- adjustment disorder, COVID-19 pandemic, traumatic stress, post-traumatic stress disorder, depression, generalized anxiety disorder, quarantine, lockdown, mental health, prevalence, Poland, gender differences, employment status
- MeSH terms
- Psychological Trauma, COVID-19, SARS-CoV-2, Adjustment Disorders, Adult, Anxiety Disorders, Depression, Female, Humans, Male, Poland, Surveys and Questionnaires, Stress Disorders, Post-Traumatic, Pandemics
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