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A 42-year-old female accountant presents with excessive worry, muscle tension, difficulty concentrating, and insomnia that began approximately 4 months ago after her company announced upcoming layoffs. She reports she has always been a 'worrier' but acknowledges that for the past several years she has also worried excessively about her children's safety, her health, finances, and her marriage, even when there were no specific stressors. She states the layoff announcement has made everything worse.
Explanation
A presenting stressor alongside a longstanding anxiety pattern can obscure the broader clinical picture. The timeline and breadth of worry beyond the presenting stressor must always be assessed, adjustment disorder is a diagnosis of exclusion.
Key Takeaway
Adjustment disorder cannot be diagnosed when full criteria for another mental disorder, such as GAD, are already met.