Baumeister Harald, Kufner Katharina
Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany.
Curr Opin Psychiatry. 2009 Jul;22(4):409-12. doi: 10.1097/YCO.0b013e32832cae5e.
A recent review highlighted the existing lack of evidence concerning adjustment disorders. It concluded that we should wait to adjust adjustment disorders until evidence is available. This is circular reasoning, fixing the poor definition of adjustment disorders. The present article outlines why we should amend adjustment disorders and which major obstacles need to be removed when revising this category.
Adjustment disorder is a frequent disorder at least in medical settings. Many of these patients do not fulfill the criteria of a more specific diagnosis, but are still regarded as 'in need of treatment'. Clinicians appreciate the possibility of assigning adjustment disorders as 'wild card' diagnoses. The drawback of this clinical utility consists in the lack of operational diagnostic specificity. This leads to the resistance of adjustment disorders being researched properly, resulting in a substantial proportion of patients receiving treatments that are not evidence based. Thus, there is a need for revision of adjustment disorders. Thereby, the border disputes of what differentiates adjustment disorders from normal human adaptation processes and from other (more specific) disorders need to be solved.
Given the high prevalence rates of adjustment disorders and their scientific neglect, it is time to revise adjustment disorders.
最近的一篇综述强调了目前关于适应障碍缺乏证据的情况。它得出结论，在有证据之前，我们应该等待对适应障碍进行调整。这是循环推理，维持了适应障碍的糟糕定义。本文概述了我们为何应修订适应障碍，以及在修订这一类别时需要消除哪些主要障碍。
适应障碍至少在医疗环境中是一种常见疾病。这些患者中的许多人不符合更具体诊断的标准，但仍被视为“需要治疗”。临床医生认可将适应障碍作为“万能”诊断的可能性。这种临床实用性的缺点在于缺乏操作性诊断特异性。这导致适应障碍难以得到恰当研究，结果相当一部分患者接受的是缺乏循证依据的治疗。因此，有必要修订适应障碍。从而，需要解决区分适应障碍与正常人类适应过程以及其他（更具体）障碍的边界争议问题。
鉴于适应障碍的高患病率及其在科学上受到的忽视，是时候修订适应障碍了。
