Adjustment disorder diagnosis: Improving clinical utility

Figures & data

Table 1. Definition and diagnostic criteria for adjustment disorders.

DSM-5	Corresponding ICD-10 criteria (ICD-10 numbering)	Proposed ICD-11 Criteria (ICD-11 Beta draft)
Belongs to category ‘Trauma- and stressor-related disorders’	Belongs to category ‘Reactions to severe stress, and adjustment disorders’	Belongs to category ‘Disorders specifically associated with stress’
A.Emotional/behavioral symptoms in response to identifiable stressor(s) Occurring within 3 months	Symptoms in response to an identifiable stressor (A) Symptoms can vary in severity and form (B) Occurring within 1 month (A)	Symptoms in response to an identifiable stressor Occurring within 1 month
B.Clinically significant as evidenced by either of the following:  (1) marked distress that is out of portion to the severity or intensity of the stressor (2) significant impairment in social or occupational or other areas of functioning	Not mentioned	Characterized by: 1.Preoccupation with the stressor or its consequences 2.Failure to adapt to the stressor 3.Symptoms cause significant impairment in personal, family, social educational, occupational or other important areas of functioning
C.Disturbance does not meet the criteria for another mental disorder and is not merely an exacerbation of preexisting mental disorders	The criteria for another specific disorder are not fulfilled (B)	Symptoms are not of sufficient specificity or severity to justify another mental disorder
D.The symptoms do not represent normal bereavement	Not mentioned	ICD-11 will include ‘Prolonged grief disorder’
E.Once the stressor (or its consequences) has terminated, the symptoms do not persist for more than an additional 6 months (ICD-10; exception is F43.21)		Typically resolves within 6 months, unless the stressor persists for a longer duration
Subtypes: 309.0 With depressed mood 309.24 With anxiety 309.28 With mixed anxiety and depressed mood 309.3 With disturbance of conduct 309.4 With mixed disturbance of emotions and conduct 309.9 unspecified	Subtypes: F43.20 Brief depressive reaction: <1 month F43.21 Prolonged depressive reaction: <2 years F43.22 Mixed anxiety and depressive reaction F43.23 Predominant disturbance of other emotions F43.24 Predominant disturbance of conduct F43.25 Mixed disturbance of emotions and conduct F43.28 With other specified predominant symptoms	No subtypes

Figure 1. Differential diagnosis for AD (ICD-11).