Background The present study explores whether severe
life-events are associated with adjustment disorders (AD)
by reanalyzing the data of a multisite epidemiological
survey (de Jong et al. in Lancet 361:2128–2130, 2003). AD
were diagnosed according to the new stress-responsemodel
of AD (Maercker et al. in Psychopathology
Method Data from 3048 persons from four different refugee
settings in Ethiopia, Algeria, Gaza, and Cambodia
were reanalyzed. Life events were assessed by an adapted
version of the Life Events and Social History Interview
(Mollica et al. in Am J Psychiatry 144:1567–1572, 1987).
The current study focuses on non-directly life threatening
events related to AD (e.g. loss of property) in contrast to
life-threatening events related to Posttraumatic Stress
Disorders (PTSD). AD Symptom measures were obtained
from available psychopathology assessments: composite
international diagnostic interview (WHO in CIDI, Geneva,
1997) and structured interview for disorders of extreme
stress (Pelcovitz et al. J Trauma Stress 10:3–16, 1997).
Results The majority of the subjects had experienced one
or more AD-related life event. Most common AD-related
life events varied across the four sites with bad shelter conditions most prevalent in Ethiopia (100%) and Gaza
(32%), forced social isolation in Algeria (61%), and lack of
food in Cambodia (41%). Prevalences of AD diagnoses
ranged from 6% (Ethiopia) to 40% (Algeria). The highest
rates of comorbidity were between AD and PTSD, followed
by anxiety disorders.
Conclusion The present study shows that the new concept
of AD can be of use for psychiatric epidemiology, e.g., in
migration contexts. The high-comorbidity rates could indicate
that AD and PTSD are parts of a stress response spectrum.