Oxman T E, Barrett J E, Freeman D H, Manheimer E
Department of Psychiatry, Dartmouth Medical School, Lebanon, NH.
Psychosomatics. 1994 Nov-Dec;35(6):557-68. doi: 10.1016/S0033-3182(94)71724-2.
The diagnosis of adjustment disorder is a dilemma in older medically ill patients. The authors conducted a prospective study of older cardiac surgery patients. Semistructured interview techniques were used to distinguish emotional impairment from physical impairment to diagnose an adjustment disorder. Among 71 patients interviewed at three points in time, 50.7% had an adjustment disorder. At 6 months after surgery, 30.6% were still showing evidence of emotional functional impairment. Continued impairment was related to initial severity of depressive and anxiety symptoms. Implications and suggestions for future research are discussed.
