The boundaries of adjustment disorder are not well de ned in the current classi cations. On the one hand, the distinction for normal adaptive reactions is not de ned and, on the other, the distinction from other diagnoses such as mood and anxiety disorders is a matter of debate.
The distinction from normal adaptive reactions is not dealt with explicitly in either classi cation. Although ICD-10 speci es that social impairment should be present in order to make the diagnosis, there is no such requirement in DSM-IV-TR. This raises the possibility that by using DSM-IV- TR the diagnosis could be applied in the face of proportionate and adaptive reactions to stressful events. This issue was raised when adjustment disorder was rst introduced into DSM-I (Fabrega 1987). At that time, it was argued that it repre- sented an attempt at medicalising problems of living. ICD-10 has to some extent recognised this danger and applied more rigorous criteria. DSM-IV-TR, on the other hand, requires that the symptoms should be clinically signi cant, although what this means is not speci ed.