In the realm of mental health, the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), is a critical guide used by professionals for diagnosis. Among its classifications are Adjustment Disorders, categorized as stressor-related disorders. Within this category, Diagnosis Code 309.24 specifically identifies an Adjustment Disorder With Anxiety. This code is assigned when anxiety is the predominant symptom in response to identifiable stressors.
According to the DSM-5, an Adjustment Disorder diagnosis, including code 309.24, requires several criteria to be met. Firstly, emotional or behavioral symptoms must develop within three months of the onset of a stressor. These symptoms must be clinically significant, indicated by either marked distress disproportionate to the stressor or significant impairment in social, occupational, or other key areas of functioning. Crucially, these disturbances should not meet the criteria for another mental disorder, nor be merely an exacerbation of a pre-existing condition, and must not represent normal bereavement. Furthermore, once the stressor or its consequences cease, the symptoms should not persist for more than an additional six months. For diagnosis code 309.24 specifically, the DSM-5 specifies “With Anxiety,” noting that nervousness, worry, jitteriness, or separation anxiety are the predominant features.
It’s important to understand how diagnostic classifications like code 309.24 fit into broader international frameworks. The International Classification of Diseases (ICD), published by the World Health Organization, also addresses Adjustment Disorders. While the DSM-5 provides the specific code 309.24 for Adjustment Disorder With Anxiety, the ICD-10 and draft ICD-11 criteria describe Adjustment Disorders as maladaptive reactions to stressors or life changes, often presenting with anxiety and depressive symptoms. The ICD emphasizes the failure to adapt to the stressor, leading to symptoms that interfere with daily functioning. Although ICD doesn’t have a direct equivalent code to 309.24, the concept of anxiety as a predominant feature in Adjustment Disorders is recognized within its diagnostic framework.
When considering a diagnosis of Adjustment Disorder With Anxiety (309.24), it’s also essential to rule out other conditions. The DSM-5 is clear that an Adjustment Disorder diagnosis is not appropriate if the symptoms better fit another, more specific psychiatric disorder, such as Generalized Anxiety Disorder or Panic Disorder, even if a stressor is present. This distinction is crucial for accurate diagnosis and appropriate treatment planning. Understanding diagnosis code 309.24, therefore, involves recognizing it as a specific subtype of Adjustment Disorder within the DSM-5, characterized by prominent anxiety symptoms in response to identifiable stressors, while also differentiating it from other anxiety and stressor-related disorders.
References
[1] World Health Organization. (1992). ICD-10: International statistical classification of diseases and related health problems. Geneva: World Health Organization.
[2] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
[3] World Health Organization. (2018). ICD-11 for Mortality and Morbidity Statistics (Version 2018). https://icd.who.int/browse11/l-m/en
[4] Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry. Wolters Kluwer Health/Lippincott Williams & Wilkins.
