Adjustment disorders: prevalence in a representative nationwide survey in Germany

Soc Psychiatry Psychiatr Epidemiol (2012) 47:17451752 DOI 10.1007/s00127-012-0493-x

ORIGINAL PAPER

Adjustment disorders: prevalence in a representative nationwide survey in Germany

Andreas Maercker Simon Forstmeier Laura Pielmaier

Lena Spangenberg Elmar Brahler Heide Glaesmer

Received: 12 September 2011 / Accepted: 25 February 2012 / Published online: 11 March 2012 Springer-Verlag 2012

AbstractObjectives This is the rst study to estimate the prevalence of adjustment disorder (AjD) in the general population. A new conceptualisation of AjD as a stress response syndrome was applied, which allowed AjD to be assessed directly from its symptom prole, including intrusive, avoidance and failure-to-adapt symptoms (Maercker et al., Psychopathology 40:135146, 2007).

Methods Prevalence rates of distressing life events and AjD were estimated from a representative sample of the German general population (n = 2,512) with a broad age range (1493 years). A questionnaire including a life events checklist and self-rating questions that assessed AjD symptoms and symptom duration were personally handed out by an interviewer.

Results The prevalence of AjD fullling the criterion of clinically signicant impairment was 0.9%; a further 1.4% of the sample was diagnosed with AjD without fullling the impairment criterion. In *72.5% of AjD cases, symptoms had developed 624 months prior to assessment.

AjD was most often associated with acute events such as moving or chronic stressors such as serious illness, conicts at the respondents job or with friends or neighbours (with *5% conditional probability each).

Conclusions The results correspond with the few other studies that have examined the prevalence of AjD, even though a new conceptualisation of the disorder was used.

Explorative results regarding the duration of AjD syndromes and symptoms call for further redenition and empirical investigation of this under-researched mental condition.

Keywords Adjustment disorders Stress-response

syndromes Survey Nationwide study

Introduction

In preparing the DSM-5 and ICD-11, new epidemiological data on adjustment disorder (AjD) are required. Because of yet unresolved validity problems, there is an increased research interest in AjD. These problems concern the conceptualisation of the disorder itself, the validity of the exclusion criterion (does not meet the criteria for another specic disorder), the time criterion (the symptoms do not persist for more than an additional 6 months), and the denition of subgroups [13]. At the same time, many good reasons justify the use of the diagnosis...