Outcomes and prognosis of adjustment disorder in adults: A systematic review

Adjustment disorder (AD) is one of the most commonly diagnosed mental health disorders and is generally conceptualized to be mild and short-lived. Despite the frequent use of AD in clinical settings, little is known about the prognosis of this condition. Our goal was to systematically review researc...

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Bibliographic Details
Published in:Journal of psychiatric research 2022-12, Vol.156, p.498-510
Main Authors: Morgan, Maria A., Kelber, Marija Spanovic, Bellanti, Dawn M., Beech, Erin H., Boyd, Courtney, Galloway, Lindsay, Ojha, Suman, Garvey Wilson, Abigail L., Otto, Jean, Belsher, Bradley E.
Format: Article
Language:English
Subjects:
Adjustment disorder
Adjustment Disorders - diagnosis
Adjustment Disorders - epidemiology
Functional impairment
Humans
Mental health
Prognosis
Suicidal Ideation
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Summary:Adjustment disorder (AD) is one of the most commonly diagnosed mental health disorders and is generally conceptualized to be mild and short-lived. Despite the frequent use of AD in clinical settings, little is known about the prognosis of this condition. Our goal was to systematically review research on a range of AD outcomes in order to provide a broad characterization of AD prognosis. We conducted searches in MEDLINE, EMBASE, and PsycINFO. We included 31 cohort or randomized controlled trials with a total of 1,385,358 participants. Many patients maintained an AD diagnosis or were diagnosed with another mental health disorder months to years after initial diagnosis. Patients with AD tended to show symptom improvement at higher rates and to utilize less treatment than did patients with other disorders. AD-diagnosed groups experienced subsequent development of numerous physical conditions, such as infection, cancers, Parkinson's disease, and cardiovascular events, at higher rates than did control groups. Results were mixed regarding suicidality and occupational impairment. We rated most studies as having a moderate risk of bias. Based on limited findings, AD appears to progress as a milder disorder than do other disorders, but it not uncommonly transitions to more severe mental health states and may predict the development of future health issues, both mental and physical. Future prospective research that conforms to prognosis study guidelines is needed to better understand the course of this common disorder.
ISSN:0022-3956
1879-1379
DOI:10.1016/j.jpsychires.2022.10.052