Adjustment Disorder with Depressed Mood
Open accessAbstract
Background: The volume of research involving adjustment disorder (AD) is limited. The scientific neglect of AD seems to result from the inadequate operationalisation of AD in DSM-IV and ICD-10. The aims of the present proposal are to discuss the shortcomings of AD conceptualisations and to present recommendations for the future. Sampling and Methods: This conceptual paper is based on an iterative process of debate between the authors. Results: The current operational definition of AD is characterised by 3 main limitations: (1) the inadequately defined clinical significance criterion, (2) the relegation of AD behind other diagnoses and (3) the missed recognition of the importance of contextual factors, such that normal human adaptive processes might be pathologised. Furthermore, subtypes of AD lack operational clarity. Based on a discussion of the limitations, recommendations for DSM-V are presented, including the addition of new subtypes. Conclusions: The revision of AD criteria will reduce the likelihood of false-positive and false-negative diagnoses. These changes will enable the scientific exploration of this common and relevant disorder, and will make epidemiological studies, and ultimately service planning based on these, more reliable than at present.
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Adjustment disorder has been a recognised diagnosis in the ICD since 1978 and in the DSM since 1980.
“adjustment disorder has been a recognised diagnosis in the ICD since 1978 2 and in the DSM since 1980. 3”
From Adjustment disorder: Implications for ICD-11 and DSM-5 (2012) · cites this paper as [2]
Table 1 (section labelled Conclusion; page unavailable) lists adjustment-disorder criteria in both DSM-IV and ICD-10, supporting its recognition in both systems. The paper passages found do not establish that recognition began in the ICD in 1978 or the DSM in 1980; searches for both dates returned no such history. (LLM, conf=0.78)
Experimental — accuracy not yet measuredThe diagnosis of adjustment disorder may be prone to a psychologist's individual interpretation because strict diagnostic criteria for adjustment disorder in the DSM-V are lacking.
“Another explanation may be the absence of clear criteria to diagnose AD, as strict diagnostic criteria for AD in the DSM-V are lacking [21]. As a consequence, the diagnosis of AD may be prone to a psychologist’s individual interpretation of the criteria.”
From Adjustment disorder in cancer patients after treatment: prevalence and acceptance of psychological treatment (2022) · cites this paper as [21]
The Abstract and Recommendations for DSM-V (page not available) describe adjustment-disorder criteria as inadequately defined and call for clearer criteria, supporting the general concern about diagnostic ambiguity. But the paper critiques DSM-IV and ICD-10 and proposes changes for DSM-V; it does not establish that strict criteria are lacking in DSM-V. Its discussion of clinical versus standardised diagnoses suggests room for interpretation, but does not specifically assess psychologists’ individual interpretations. (LLM, conf=0.88)
Experimental — accuracy not yet measuredDer fehlende Zusammenhang zwischen höherem Schulabschluss und Inanspruchnahme zeigt sich auch in verschiedenen früheren Studien, während in anderen Studien höhere Bildung mit höherer Inanspruchnahme einherging.
“Dies zeigt sich auch in verschiedenen früheren Studien [ 32 , 33 , 55 ] , während in anderen Studien höhere Bildung mit höherer Inanspruchnahme einherging [ 31 , 53 ] .”
From Inanspruchnahmebereitschaft und Inanspruchnahmeverhalten von Behandlungen aufgrund psychischer Belastungen bei Patienten der somatischen Rehabilitation (2012) · cites this paper as [32]
The passages on treatment-seeking (Criterion B; page unavailable) and service use (Criterion C; page unavailable) do not relate either to educational attainment. Searches for education, school qualifications, and healthcare utilisation found no passage in our copy addressing whether higher education is associated with service use. (LLM, conf=0.73)
Experimental — accuracy not yet measured
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van Beek, F. E., Wijnhoven, L. M. A., Jansen, F., Custers, J. A. E., Aukema, E. J., Coupé, V. M. H., Cuijpers, P., van der Lee, M. L., Lissenberg-Witte, B. I., Wijnen, B., et al. (2019) · BMC Psychology · doi:10.1186/s40359-019-0368-y · Cited by 13 · see citing works
Jannini, T. B., Rossi, R., Socci, V., Reda, F., Pacitti, F., & Lorenzo, G. D. (2022) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2813 · Cited by 13 · see citing works
Montero‐Marín, J., Collado‐Navarro, C., Navarro‐Gil, M., López-Montoyo, A., Demarzo, M., Herrera‐Mercadal, P., Barceló‐Soler, A., & García‐Campayo, J. (2019) · BMJ Open · doi:10.1136/bmjopen-2019-029909 · Cited by 13 · see citing works
Zimmerman, M. A., Martinez, J. H., Dalrymple, K. L., Chelminski, I., & Young, D. (2013) · Annals of Clinical Psychiatry · doi:10.1177/104012371302500404 · Cited by 12 · see citing works
Sleep Disturbance in Adjustment Disorder and Depressive Episode
Doherty, A. M., Lorenz, L., Jabbar, F., O’Leary, E., & Casey, P. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16061083 · Cited by 10 · see citing works
“It is well recognized that many of the biological symptoms of depression are commonly seen in AD [4,5], and certain symptoms such as suicidal ideation are equally common in both conditions [6].”
Self-citationAdjustment disorder considered
Casey, P., & Jabbar, F. (2013) · Advances in Psychiatric Treatment · doi:10.1192/apt.bp.111.010058 · Cited by 10 · see citing works
Self-citationAndreu‐Mateu, S., Botella, C., Quero, S., Guillén, V., & Baños, R. (2012) · Repositori UJI (Universitat Jaume I) · Cited by 10 · see citing works
Kajosch, H., Gallhofer, B., Corten, P., From, L., Verbanck, P., & Campanella, S. (2016) · Clinical Neurophysiology · doi:10.1016/j.clinph.2016.07.009 · Cited by 9 · see citing works
Baumeister, H., Kury, S., & Bengel, J. (2010) · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz · doi:10.1007/s00103-010-1179-8 · Cited by 9 · see citing works
Self-citationDiagnosing adjustment disorder with depressive features
Casey, P. (2008) · Expert Review of Neurotherapeutics · doi:10.1586/14737175.8.8.1203 · Cited by 9 · see citing works
Self-citationTerrazas, E. E., López, A. G., Ramírez, R., & Rada, Á. P. (2010) · Medicina Clínica · doi:10.1016/j.medcli.2010.05.018 · Cited by 8 · see citing works
Balon, R. (2010) · Journal of Sex & Marital Therapy · doi:10.1080/00926230903375529 · Cited by 8 · see citing works
“As Baumeister, Maercker, and Casey (2009) point out, the utility of this concept has been recognized for over 50 years.”
BackgroundDoherty, A. M., Crudden, G., Jabbar, F., Sheehan, J. D., & Casey, P. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16203970 · Cited by 6 · see citing works
Self-citationJahed, J., Bengel, J., & Baumeister, H. (2012) · Die Rehabilitation · doi:10.1055/s-0032-1308964 · Cited by 4 · see citing works
Self-citationAdjustment disorder or adaptive adjustment?
Casey, P. (2020) · BJPsych Advances · doi:10.1192/bja.2020.74 · Cited by 4 · see citing works
Self-citationTherapy of the Adjustment Disorder
Baumeister, H., Bachem, R., & Domhardt, M. (2022) · Springer eBooks · doi:10.1007/978-3-662-64057-9_21 · Cited by 4 · see citing works
Self-citationTherapie der Anpassungsstörung
Baumeister, H., Bachem, R., & Domhardt, M. (2019) · Springer eBooks · doi:10.1007/978-3-662-58470-5_21 · Cited by 3 · see citing works
Self-citationBai, M., Cella, D. F., Jeon, S., Govindarajan, R., & Birrer, M. J. (2025) · Journal of Psychosocial Oncology · doi:10.1080/07347332.2025.2450013 · Cited by 2 · see citing works
Diagnostik und Indikationsstellung bei psychischen Belastungen und Störungen
Baumeister, H. (2016) · Springer eBooks · doi:10.1007/978-3-662-47972-8_4 · Cited by 2 · see citing works
Self-citation5.1 PTSD and beyond: Embitterment and relevant concepts of nosology
Maercker, A. R. A. (2011) · Springer eBooks · doi:10.1007/978-3-211-99741-3_19 · Cited by 2 · see citing works
Self-citationExploring the feeling of embitterment in the workplace.
Michailidis, E. (2017) · Surrey Research Insight Open Access (The University of Surrey) · Cited by 2 · see citing works
Maercker, A. R. A., Bachem, R., & Simmen‐Janevska, K. (2015) · The Encyclopedia of Clinical Psychology · doi:10.1002/9781118625392.wbecp332 · Cited by 2 · see citing works
Self-citationAlmaghrebi, A. H., AlHajjar, L. M., Alkusayer, A., Zahrani, S. A., & Jumah, M. A. (2023) · Research Square · doi:10.21203/rs.3.rs-3705219/v1 · Cited by 2 · see citing works
Adjustment Disorders: Diagnostic and Treatment Issues
Casey, P., Frcpi, FRCPsych, Doherty, A. M., MBBCh, MedS, & MRCPsych (2013) · Cited by 1 · see citing works
Self-citationSomatopsychische Komorbidität: Definition und Verständnis
Baumeister, H., Kury, S., & Bengel, J. (2011) · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz · Cited by 1 · see citing works
Self-citationDiagnostik und Indikationsstellung bei psychischen Belastungen und Störungen
Baumeister, H. (2020) · Springer eBooks · doi:10.1007/978-3-662-61170-8_4 · Cited by 1 · see citing works
Self-citationWijnhoven, L. M. A., van Zutphen, L., Custers, J. A. E., van Beek, F. E., Holtmaat, K., Jansen, F., Leeuw, I. M. V., Kwakkenbos, L., & Prins, J. B. (2024) · Journal of Psychosocial Oncology Research and Practice · doi:10.1097/or9.0000000000000127 · Cited by 1 · see citing works
“18 It has also been argued that increased distress after a life event like a cancer diagnosis should be considered a normal stress reaction, and diagnosing a mental disorder medicalizes problems of living.”
BackgroundA descriptive study of claims for occupational mental disorder: adjustment disorder
Kim, K., Kim, I., & Youn, K. (2020) · Annals of Occupational and Environmental Medicine · doi:10.35371/aoem.2020.32.e39 · Cited by 1 · see citing works
Bengel, J., Hecht, H., & Frommberger, U. (2019) · Elsevier eBooks · doi:10.1016/b978-3-437-22485-0.00015-4 · Cited by 1 · see citing works
Reactive mental disorders: stressors, personality and symptoms
Casey, P. (2011) · Springer eBooks · doi:10.1007/978-3-211-99741-3_25 · Cited by 1 · see citing works
“These considerations point to the necessity for a clearer enunciation of the diagnostic criteria for AjD (Baumeister et al. 2009) so that it will be clearly delineated from normal reactions to life stressors and from other overlapping disorders such as major depression.”
BackgroundInfluentialSelf-citationValidität eines neuen diagnostischen Konzeptes für Anpassungsstörungen
Köllner, V. (2011)
A view beyond the horizon: a prospective cohort study on mental health and long-term disability
Cornelius, L. R. (2013) · University of Groningen research database (University of Groningen / Centre for Information Technology)
Cadre conceptuel et controverses dans les troubles de l’adaptation
Strain, J. J., Casey, P. R., & Psych, F. R. C. (2018) · Elsevier eBooks · doi:10.1016/b978-2-294-75659-7.00003-7
Self-citationLimite entre réponses normales et pathologiques
Casey, P. R., & Psych, F. R. C. (2018) · Elsevier eBooks · doi:10.1016/b978-2-294-75659-7.00001-3
Self-citationBengel, J., Hecht, H., & Frommberger, U. (2012) · Elsevier eBooks · doi:10.1016/b978-3-437-22483-6.10015-4
What Is Psychopathology? Controversies in Classifying Psychiatric Disorders
Casey, P., & Kelly, B. D. (2019) · Cambridge University Press eBooks · doi:10.1017/9781108578264.002
Self-citationWebb, A., Ford, S. C., & Santiago, P. N. (2018) · Oxford University Press eBooks · doi:10.1093/med/9780190457136.003.0005
Casey, P., & Kelly, B. D. (2024) · Cambridge University Press eBooks · doi:10.1017/9781009372688.003
Self-citationPsychological Adaptation to Newly Diagnosed Advanced Cancer
Bai, M., & Harris, M. (2025) · Advances in Family Practice Nursing · doi:10.1016/j.yfpn.2024.12.002
Nakagawa, A., Mitsuda, D., Umegaki, Y., Bachem, R., Nogami, W., Higuchi, R., Ito, A., & Kocha, H. (2025) · Psychiatry and Clinical Neurosciences Reports · doi:10.1002/pcn5.70104
Ferolino, A. J. P., Mordeno, I. G., & Ducay, J. (2026) · Measurement and Evaluation in Counseling and Development · doi:10.1080/07481756.2026.2649584
“…[i.e. excessive worry, nervousness, restlessness (O’Donnell et al., 2016; Ohi et al., 2023; Vanin et al., 2008)], and depression [i.e. loss of interest, sleep disturbances, problems in concentration, fatigue, and low energy (Baumeister et al., 2009; Doherty et al., 2019; Maercker et al., 2013)].”
Kupferschmitt, A. A., Köllner, V., & Bachem, R. (2026) · Health Psychology and Behavioral Medicine · doi:10.1080/21642850.2026.2714623
“The AjD concept has therefore been criticised for its conceptual vagueness, limited reliability, and restricted discriminant validity (e.g. Baumeister et al., 2009; Reed et al., 2011).”
Nosologie und Epidemiologie psychischer Störungen
Hengartner, M. P. (2026) · Angewandte Psychologie Kompakt · doi:10.1007/978-3-662-72845-1_3
Almaghrebi, A. H., AlHajjar, L. M., Alkusayer, A., Zahrani, S. A., & Jumah, M. A. (2026) · The Egyptian Journal of Neurology Psychiatry and Neurosurgery · doi:10.1186/s41983-026-01232-y
Pharmacist interventions in depressed patients
Valera, M. R. (2012) · LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas)
- Authors
- Baumeister, H., Maercker, A., & Casey, P.
- Affiliations
- University of Freiburg (DE)
- University College Dublin (IE)
- Venue
- Psychopathology
- Publisher
- S. Karger AG
- Published
- 2009
- Volume
- 42
- Issue
- 3
- Pages
- 139-147
- ISSN
- 0254-4962 (ISSN-L)
- 1423-033X
- OpenAlex
- W2026577555
- Cited by
- 92
- References
- 41
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 2 · 2023: 1 · 2022: 4 · 2021: 3 · 2020: 3 · 2019: 9 · 2018: 5 · 2017: 4 · 2016: 5 · 2015: 4 · 2014: 5 · 2013: 5 · 2012: 12
- FWCI
- 96.90
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psychopathology (publishedVersion)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, other-oa)
- Arrow@dit (Dublin Institute of Technology) (submittedVersion)
- Research Repository UCD (University College Dublin) (submittedVersion, cc-by-nc-nd)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, other-oa)
- Zurich Open Repository and Archive (University of Zurich)
- Topics
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
- Keywords
- adjustment disorder, depressive mood, diagnostic criteria, DSM-V, ICD-10, operational definitions, contextual factors, diagnostic subtypes, DSM-IV
- MeSH terms
- Adjustment Disorders, Depression, Forecasting, Humans, Guidelines as Topic, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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