Adaptation disorders

Marcos is 27 years old and his grandfather died a week ago. The relationship between the two was always very close. When Marcos was little and his parents had to travel for work, they always left him with his grandparents. The relationship with his grandmother was also fantastic, but Marcos's predilection was his grandfather. The day he died, Marcos seemed not to flinch, but After a week he began to express altered behaviors. He stopped going to work and going out with his friends, was bad and irrascible. Possibly Marcos was suffering one of the adaptation disorders.

Adaptation disorders are included in the "disorders related to traumas and stress factors". They are called "disorders" and not "disorder" because different symptoms can predominate, for example and as will be seen later, you can highlight anxiety, depressed mood, behavior alteration, etc. Throughout the article the diagnostic criteria, the types, the main characteristics, the course and development and the treatment will be addressed.

Content

• Diagnostic criteria of adaptation disorders
• Characteristics of adaptation disorders
• Development and course
• Treatment
  • Psychotherapy
  • Pharmacology
  • Bibliography

Diagnostic criteria of adaptation disorders

The diagnostic criteria of the adaptation disorder will be defined through the latest update of the diagnostic and statistical manual of mental disorders, the DSM-5 (2014).

TO. Development of emotional or behavior symptoms in response to a stress factor or factors identifiable that occur in the three months following the beginning of the stress factor (s).

B. These symptoms or behaviors are clinically significant, as revealed by one or the following two characteristics:

1. Intense discomfort disproportionate to the severity or intensity of the stress factor, Taking into account the external context and cultural factors that could influence the severity and presentation of symptoms.
2. Significant social, labor deterioration or other important areas of operation.

C. Stress -related alteration does not meet criteria for another mental disorder And it is not simply an exacerbation of a pre -existing mental disorder.

D. The symptoms They do not represent the normal duel.

AND. Once the stress factor or its consequences have ended, Symptoms are not maintained for more than six months.

It should be specified if it occurs with:

• Depressed mood: low mood predominates, the desire to cry or the feeling of hopelessness.
• Anxiety: nervousness, concern, agitation or separation anxiety predominates.
• Mixed anxiety and depressed mood: A combination of depression and anxiety predominates.
• Behavior alteration: behavior alteration predominates.
• Mixed alteration of emotions and behavior: Emotional symptoms predominate (example: depression and anxiety) and behavior alteration.
• Unspecified: For bad adaptation reactions that cannot be classified as one of the specific subtypes of adaptation disorder.

It should also be specified whether the alteration lasts less than six months (acute) or lasts six months or more (persistent).

Characteristics of adaptation disorders

As described Suárez, Iglesias and Cañive (2011): "In all adaptation disorders, the reaction to the stressful factor seems to be an intensification of the normal reaction or a reaction that interferes significantly in the normal course of social, educational activities or occupations". The central characteristic of this disorder consists of presence of behavioral or emotional symptoms in response to an identifiable stress factor. The most frequent behavioral forms consist of: aggressiveness, hostility, substance abuse, challenge, promiscuity and antisocial acts.

This stress factor can be generated from a single event (for example, the dismissal of a job) or can be caused by multiple factors Stress triggers (for example: work problems, couple and family at the same time). Stress factors are diverse and can affect both a single person, as a couple, a larger group or a whole community (for example, a natural disaster).

Adaptation disorders can be diagnosed, for example, after the death of a loved one. In the diagnosis it is essential that The intensity, quality or persistence of grief reactions exceed what could normally be expected, Taking into account cultural, religious or appropriate norms for age. Adaptation disorders have been related to a higher risk of suicide attempts and consummate suicides.

Development and course

In general, Alterations in adaptation disorder begin within three months after the start of a stress factor or factors And it does not last more than six months after the end of the stressful agent or its consequences. If the stressful factor is an acute event (for example, being fired), the beginning of the alteration is usually immediate (in a few days after the dismissal) and the duration is relatively short (a few months). If the stressful factor or its consequences are lengthened over time, the adaptation disorder could continue and would become its persistent form.

Treatment

Treatment in adaptation disorders is usually effective. Duration depends on each person and circumstances, however, at the general level they are not usually very long treatments. When dealing with persistent adaptation disorders, treatment can be extended over time. The most effective treatments are psychotherapy, pharmacology or both.

Psychotherapy

Psychological therapy, without a doubt, is one of the best alternatives in the treatment of adaptation disorders. According to the type of disorder and event, therapy may be individual, as a family or in a broader group. Through therapy, it is intended: Provide emotional support, teach skills to manage stress, Help to return to the usual habits and help to know the reason why the event affected so disproportionately.

Pharmacology

Medications will always have to be prescribed if necessary by a medicine professional. The most used are usually antidepressants and anxiety medications. The duration of family therapy will depend on the criteria of the professional and the patient's advances. However, it is very important not to abandon medications although we notice a great improvement, since a large amount of antidepressants can generate withdrawal syndrome.

Bibliography

American Psychiatric Association. (2014). DSM-5. Diagnostic and Statistical Manual of Mental Disorders. Madrid: Pan American Medical Editorial.

Suárez, d., Iglesias, j. and Cañive, C. (2011). Adaptation disorder in child psychopathology. Journal of the Faculty of Health Sciences, 8(2), 213-225.