The Zurich Adjustment Disorder Study: Diagnostics and Risk Factors of ICD-11 Adjustment Disorder Following Involuntary Job Loss

Louisa Lorenz, Lisa Makowski, Andreas Maercker


As part of the trauma and stress-related disorders’ category, adjustment disorder is
a frequently occurring mental disorder that develops after stressful life events.
Preoccupation and failure to adapt are the core symptoms of adjustment disorder
in ICD-11. As this is a new definition, we conducted a large-scale study to gain a
deeper understanding of the validity and applicability of the revised diagnostic
criteria. N=334 individuals who experienced involuntary job loss were interviewed
three times one to nine months after the last day at work (immediately, six- and
twelve-months follow-up). For measuring adjustment disorder symptoms, a newly
developed structured diagnostic interview and a self-report questionnaire evidenced
satisfying psychometric properties. Approximately six months after discharge, the
prevalence of a tentative diagnosis of adjustment disorder was 27.3% and
decreased to 10.5% over the course of 12 months. We identified several event-
/person-related, intra- and interpersonal correlates and predictors of adjustment
disorder symptoms. The more specific definition of adjustment disorder, which
leads to an improved detection of adjustment disorder cases, is in line with WHO's
aim of improved ease of use of the disorder.


ICD-11; DSM-5; adjustment disorder; stress-related disorders; job loss.

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