Lorenz Louisa, Maercker Andreas, Bachem Rahel
Department of Psychology, University of Zurich, Zurich, Switzerland.
Clin Psychol Eur. 2020 Sep 30;2(3):e3027. doi: 10.32872/cpe.v2i3.3027. eCollection 2020 Sep.
After its redefinition in ICD-11, adjustment disorder (AjD) comprises two core symptom clusters of preoccupations and failure to adapt to the stressor. Only a few studies investigate the course of AjD over time and the definition of six months until the remission of the disorder is based on little to no empirical evidence. The aim of the present study was to investigate the course of AjD symptoms and symptom clusters over time and to longitudinally evaluate predictors of AjD symptom severity.
A selective sample of the Zurich Adjustment Disorder Study, N = 105 individuals who experienced involuntary job loss and reported either high or low symptom severity at first assessment (t1), were assessed M = 3.4 (SD = 2.1) months after the last day at work, and followed up six (t2) and twelve months (t3) later. They completed a fully structured diagnostic interview for AjD and self-report questionnaires.
The prevalence of AjD was 21.9% at t1, 6.7% at t2, and dropped to 2.9% at t3. All individual symptoms and symptom clusters showed declines in prevalence rates across the three assessments. A hierarchical regression analysis of symptoms at t3 revealed that more symptoms at the first assessment (β = 0.32, p = .002) and the number of new life events between the first assessment and t3 (β = 0.29, p = .004) significantly predicted the number of AjD symptoms at t3.
Although prevalence rates of AjD declined over time, a significant proportion of individuals still experienced AjD symptoms after six months. Future research should focus on the specific mechanisms underlying the course of AjD.
在《国际疾病分类第11版》（ICD - 11）对其重新定义后，适应障碍（AjD）包含两个核心症状群，即过度担忧和无法适应应激源。仅有少数研究调查了适应障碍随时间的病程，且关于该障碍缓解前六个月的定义几乎没有实证依据。本研究的目的是调查适应障碍症状及症状群随时间的病程，并纵向评估适应障碍症状严重程度的预测因素。
苏黎世适应障碍研究的一个选择性样本，N = 105名经历非自愿失业且在首次评估（t1）时报告症状严重程度高或低的个体，在工作的最后一天后平均M = 3.4（标准差 = 2.1）个月进行评估，并在六个月后（t2）和十二个月后（t3）进行随访。他们完成了一份针对适应障碍的完全结构化诊断访谈和自我报告问卷。
适应障碍的患病率在t1时为21.9%，在t2时为6.7%，在t3时降至2.9%。所有个体症状及症状群在三次评估中的患病率均呈下降趋势。对t3时症状的分层回归分析显示，首次评估时更多的症状（β = 0.32，p = .002）以及首次评估与t3之间新发生生活事件的数量（β = 0.29，p = .004）显著预测了t3时适应障碍症状的数量。
尽管适应障碍的患病率随时间下降，但仍有相当比例的个体在六个月后仍经历适应障碍症状。未来的研究应关注适应障碍病程背后的具体机制。
