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Minerva Psichiatrica 2014 June;55(2):69-76

language: English

Diagnosing adjustment disorder correctly: is working out possible? Survey of the skills of a group of mental health workers

Fei L. 1, Garro M. 2, Rimediotti S. 1

1 Unit of Psycho-Oncology, Careggi University Hospital, Florence, Italy;
2 Unit of Psychiatry, Caravaggio Hospital Treviglio, Bergamo, Italy


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AIM: Adjustment disorder (AD), a common psychiatric disorder in internal medicine according to the DSM, characterizes as a controversial nosographic issue because of uncertain boundaries as the presence of symptomatology that overlaps with AD and because of objective difficulty in differentiating between psychopathologies and homeostatic reactions to life event. So an exact diagnosis could turn out to be achieved hard. The aim of this study is to investigate skills in diagnosing Adjustment Disorder by mental health workers.
METHODS: A descriptive survey involving a heterogeneous group of 100 qualified practitioners or residents in psychiatry or psychology was carried out. The submission of a brief questionnaire about the diagnosis, prognosis and clinical features of a case recognizable as AD was performed. Answers were compared according to different occupational and academic characteristics. Statistical evaluations were performed through a contingency analysis.
RESULTS: A correct diagnosis was achieved by the majority of the sample (~70%) without relevant differences among the subgroups. Conversely, a clear lack of skill was observed in defining the issues which could discriminate an AD from other psychiatric disorders with similar symptomatology. Moreover, no significant difference with regard to overall assessment abilities was observed between qualified practitioners and residents within either the psychiatric or psychological subgroups.
CONCLUSION: AD is well known as a nosographic item, but its actual clinical usefulness seems to be called into question owing to controversial and inconclusive issues. The diagnosis could be performed more accurately if diagnostic criteria might be completed with pathogenesis-linked specific aspects.

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