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¿Amenaza ante el cambio?: Trastorno de adaptación

¿Amenaza ante el cambio?: Trastorno de adaptación

julio 8, 2021 by Editor CLICC5745
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Ante una situación de crisis sanitaria, como la actual pandemia por COVID-19 se han tenido que aplicar medidas de salud pública para contrarrestar la propagación del virus. Las cuales han afectado significativamente el entorno social, emocional y económico de las personas, entre estos se incluyen el desempleo, distanciamiento social y físico, tener COVID-19 y la pérdida de seres queridos.  Los cuales son precursores del desarrollo de problemas en la salud mental.
La actual pandemia ha generado que gran parte de la población de todo el mundo lleve a cabo un confinamiento sanitario, el cual ha desencadenado sentimientos como el miedo, la preocupación o el estrés. Los cuales son respuestas normales ante este tipo de situaciones que involucran la incertidumbre o cambios abruptos en la vida cotidiana, así como un conjunto de factores estresantes constantes. Sin embargo, es importante destacar que si uno de estos síntomas sale de los rangos normales ante la respuesta del evento estresante o le está generando demasiada dificultad en su vida, podría estar pasando por un trastorno de adaptación.
De acuerdo con diversos estudios realizados en diferentes países, los problemas de salud mental han incrementado significativamente, entre los problemas con mayor aumento durante la pandemia destacan la depresión, la ansiedad, el insomnio, el trastorno de estrés postraumático y el trastorno de adaptación.
Personas con un nivel socioeconómico bajo son más susceptibles a desencadenar problemas de salud mental como el Trastorno de adaptación, por la incertidumbre de las cuestiones financieras, así como aquellas personas que tienen un consumo frecuente de noticias sobre la pandemia, aquellas que han padecido condiciones previas o actuales de  salud física o mental, exposiciones previas a traumas, así como las que han sido diagnosticadas con COVID-19 o han estado expuestas a personas con el diagnóstico. Estos determinantes son factores estresantes y de riesgo a desarrollar secuelas emocionales y mentales.  
¿Qué es?
Cuando se habla del trastorno de adaptación se refiere a un conjunto de sintomatologías relacionadas al estrés agudo y crónico. Se manifiesta mediante reacciones emocionales y comportamentales exageradas que alteran diversos factores de la vida. Se presenta dentro de los primeros tres meses en relación con el factor estresante identificado. 
¿Cuáles son sus características?
Como se mencionó anteriormente, el trastorno de adaptación suele ser resultado de alguna situación estresante como lo son, perder el trabajo, iniciar un cambio en la rutina diaria, ser diagnosticados con alguna enfermedad, entre otras. 
Este trastorno se caracteriza por los siguientes síntomas:
  • Síntomas depresivos
  • Tristeza
  • Desesperanza
  • Llanto
  • Poco interés por realizar tareas que le resultaban agradables
  •  Síntomas ansiosos 
  • Preocupación
  • Angustia
  • Tensión
  • Nerviosismo 
  • Síntomas del comportamiento
  • Agresividad
  • Autolesiones
  • Dificultad para concentrarse 
  • Aislamiento social
  • Evitación de asuntos importantes como el trabajo y la escuela
  • Trastornos del sueño y apetito
  • Combinaciones mixtas de los síntomas mencionados.
Es importante señalar que, para ser identificado como Trastorno de adaptación no es necesaria la presencia de todos los síntomas enlistados anteriormente. La presencia de este trastorno se diferencia, ya que, alguno o varios de los síntomas se expresan a partir de un factor estresante y suelen durar por un corto periodo de tiempo. 
Suele presentarse principalmente  en niños y adolescentes, pero en los últimos meses, derivado a la pandemia por COVID-19, ha existido un aumento de casos en adultos.
Los criterios diagnósticos determinados por el DSM-5, que se destacan de este trastorno son cinco:
  • Los síntomas se presentan dentro de los tres meses desde que inició el factor estresante
  • Las reacciones al estrés deben ser exageradas comparadas con la reacción normal ante el factor estresante y con alteraciones significativas en áreas importantes de la vida.
  • Las alteraciones no deben ser una agravación de otros trastornos mentales.
  • No puede considerarse en reacciones de duelo normales. 
  • Se tiende a desaparecer 6 meses después de la finalización del factor estresante. 
Si bien, es común que este trastorno finalice en los 6 meses posteriores  al término de los estresores, también, se ha identificado que existe un trastorno de adaptación crónico que podría derivar en un Trastorno depresivo mayor, si no es tratada a tiempo, así como se ha relacionado también con conductas de abuso de sustancias y tendencias suicidas, por ende es importante recalcar la importancia de ser dirigidos con un experto en la salud mental.
De acuerdo con lo presentado anteriormente, a continuación brindamos algunas recomendaciones:
  • Crear una rutina diaria que fomente hábitos que mejoren el bienestar.
  • Expresar las emociones detonadas a partir de la pandemia.
  • Mantener interacción social con amigos, familia y compañeros del trabajo.
  • Buscar apoyo psicológico de ser necesario. 
Referencias
Ezra, B., Kai, W. y Goodwin, R. (2021). Investigating the relationship between COVID-19-related and distress and ICD-11 adjustment disorder: two cross-sectional studies. BjPsych Open, 7(21), 1-7, doi: 10.1192/bjo.2020.158 
Lotzin, A., Acquarino, E., Adjukovic, D., Ardino, V., Böttche, M., Bondjers, K., Bragesjö, M., Dragan, M., Grajewski, P., Figueiredo, M., Gelezelyte, O., Darejan, J., Kazlauskas, E., Knefel, M., Lueger, B., Makhashvili, N., Mooren, T., Sales, L., Stevanovic, A. y Schäfer, I. (2020). Stressors, coping and symptoms of adjustment disorder in the course of the COVID-19 pandemic – study protocol of the European Society for Traumatic Stress Studies (ESTSS) pan-European study.  European Journal of Psychotraumatology, 11(1), 1-9, doi:10.1080/20008198.2020.1780832
Ramírez, J., Castro, D., Lerma, C., Yela, F. y Escobar, F. (2021). Consecuencias de la pandemia de la Covid-19 en la salud mental asociadas al aislamiento social. Colombian Journal of Anesthesiology, 48(4), 1-8.Doi:https://doi.org/10.5554/22562087.e930 
Zelviene, P. y Kazlauskas, E. (2019). Adjustment disorder: current perspectives. Neuropsychiatric Disease and Treatment, 2018(4), 375-381, https://doi.org/10.2147/NDT.S121072 

 

 

 


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