Evaluation of a New Concept for Diagnosing Adjustment Disorders in a Psychosomatic Setting

Objective Diagnoses of adjustment disorders are frequent in clinical settings, although diagnostic criteria are not very reliable or valid. This has led to a neglection of this topic in research. This article presents and applies a new concept (Maercker et al., 2007) for diagnosing adjustment disorders. Methods 96 patients of a psychosomatic policlinic were examined regarding their emotional well-being with a new questionnaire (Adjustment Disorder - New Module vertical bar ADNM). Furthermore, according to the new concept, adjustment disorders were assessed with a structured interview. Coping behaviour (CISS) as well as general self efficacy (SWE) in patients with scores within a normal range and patients with elevated scores in ADNM, respectively, were examined. The following statistical measures were used: Cluster analysis, cross tables, non-metrical and metrical test procedures. Results The theory-guided evaluation of the ADNM questionnaire divided the whole sample into patients with elevated (49%) and with normal (51%) scores. A cluster analysis of patients with elevated scores showed two groups, so that a total of three groups were compared: patients with scores in a normal range; patients with elevated scores and a low number of symptoms; patients with elevated scores and a high number of symptoms. Patients with elevated scores showed significantly more emotion-oriented coping strategies (t = -6.338; p = 0.000) and reported, referring to present stress, on being less able to cope with it (Z = -4.445; p = 0.000). Patients with elevated scores and a high number of symptoms named more stress factors (Z = -2.634; p = 0.008) and reported on being more impulsive and irritable (Z = - 3.406; p = 0.003). The comparison of the ADNM questionnaire and the clinical main diagnoses shows a separation between emotional and non-emotional disturbances according to ICD-10 (chi(2)((2, n = 96)) = 6.928; p = 0.031). Discussion The results show that the ADNM questionnaire according to the new diagnostic concept of adjustment disorders (Maercker et al., 2007) identifies patients who experience a high degree of stress caused by adverse life events of life conditions. The ADNM reliably differentiates non-emotional from emotional ICD-10 diagnoses. Further Studies should examine, whether the new concept as well as the questionnaire are able to assess adjustment disorders in a valid and reliable way.