Adjustment Disorder With Anxiety

Adjustment disorder with anxiety involves the development of clinically significant anxiety in response to identifiable psychosocial stressors, such as occupational, interpersonal, or financial challenges. Pathophysiology involves dysregulation of stress-response systems, including hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis and heightened sympathetic nervous system activity. Patients often exhibit excessive worry, nervousness, restlessness, and difficulty concentrating, which are disproportionate to the severity of the stressor. Diagnosis is clinical, requiring symptom onset within three months of the stressor and significant functional impairment, while ruling out other anxiety or mood disorders. Treatment focuses on brief psychotherapy, stress management, and sometimes short-term pharmacologic intervention for anxiety symptoms. Prognosis is typically favorable, with symptom resolution expected once the stressor is removed or effectively managed.