Adjustment Disorder in U.S. Service Members: Factors Associated With Early Separation

ABSTRACT Introduction Adjustment disorder (AD) is a time-delimited characterized by excessive emotional distress or impaired functioning in response to an identifiable stressor. Although it commonly diagnosed mental health settings, its impact on occupational, social and other areas of not well understood. As subthreshold that frequently conjunction with physical disorders, the extent contribution functional impairment may be obscured. During military service, research suggests AD early-service trainees. To help elucidate relationship between outcome, we explored 2 factors associated rate separation from service U.S. active duty members (SMs) diagnosis: previous diagnoses time when SMs receive incident diagnosis (IADx). Materials Methods Twenty-thousand IADx were grouped whether this was their first received military. assess impairment, groups compared separation. Those without prior then stratified into 5 based length entrance receipt further analyzed for rates. The Cox model used determine hazard ratios create survival curves. study determined “not human subjects research.” Results Nearly half (46.4%) previously had increased risk [hazard ratio = 1.25 (95% confidence interval: 1.207-1.286)]. Of as diagnosis, 19.3% during 6 months highest separating 1.48 (1.381-1.589)], 60% probability within years diagnosis. receiving second (16.2%), year (20.1%), third (18.2%) approximately 47% years. Conclusions Previous appear important AD. those mood, anxiety, disorders at higher following IADx. Our findings are entered electronic records, so cannot identify nature stressor precipitated Nonetheless, early predicted fastest separation, opportune interventions reduce outcomes.