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Adjustment disorders and anxiety 

Adjustment disorders and anxiety
Chapter:
Adjustment disorders and anxiety
Author(s):

Simon Wein

and Limor Amit

DOI:
10.1093/med/9780199656097.003.0174
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date: 18 April 2021

Adjustment disorders and anxiety are two of the more common responses to stressors in palliative care. At one end of the spectrum, adjustment and anxiety are normal defences. However, when coping mechanisms fail these responses can become pathological. Judging when a response is pathological is based on two principles: the severity of symptoms and the extent of disruption of normal functioning or homeostatic adaptation. The intimate two-way relationship between physical and psychological symptoms in palliative care means that physical symptoms have to be well controlled and that psychological symptoms can be masked by physical complaints. Management principles include talking therapies, psychopharmacology, and complementary treatments. Examples of innovative psychological treatments are dignity therapy and meaning-centred therapy. Every palliative care intervention requires consideration of the family and it is also important to monitor anxiety and adjustment of the staff who are also prone to burn-out, compassion fatigue, and difficulties in adjusting to stressors.

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