Psychobiology of adjustment disorder
Biological studies are scarce but some are slowly emerging that show differences between adjustment disorder and major depression. In individuals expressing suicidal ideation, post-dexamethasone suppression of cortisol levels was negatively correlated with symptom scores only in those with a diagnosis of major depression; there was no correlation in those with adjustment disorder (Lindqvist 2008). Among people with adjustment disorder in the context of workplace bullying (Rocco 2007; Di Rosa 2009), dexamethasone suppression test and other aspects of the hypothalamus–pituitary–adrenal axis were found to be normal. Although limited in number and scope, these studies point to a distinction between major depression/depressive episode and adjustment disorder.