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Author Topic: Adjustment Reaction With Mixed Emotional Features  (Read 5444 times)

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« on: June 12, 2011, 09:05:27 PM »

I hope I'm posting this in the right area. I've read in several places now that many times insurance won't cover treatment for BPD. I've also read that a pwBPD will often reject a diagnosis should a therapist attempt to make one. Given those sticky situations, it seems therapists may have to work around the issue with a client if they want to keep them in their care.

My uH has been attending therapy for about a year now, and at one point communicated he was being treated for PTSD. However I just happened to notice, looking at a recent insurance bill, that his diagnostic code is "Adjustment Reaction With Mixed Emotional Features."

Are there any professional members out there that can shed some light on this diagnosis and in what circumstances they would apply it to a client. I can't find a lot of information on the Googles.


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Please do not host topics related to the specific pwBPD in your life - those discussions should be hosted on an appropraite [L1] - [L4] board.

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« Reply #1 on: July 06, 2011, 02:54:16 PM »

 It just sounds like what I often see...

a plausible, likely, possibly even co-morbid 'insurable' axis I diagnosis instead of axis II since insurance companies see Axis ii as untreatable or at the very least,  needing long term treatment...and so they don't cover it.

So I see clinicians all the time looking through the DSM to find something desrcriptive of symptoms,  but not too serious, non stigmatizing, and treatable under axis I and they use that as the diagnosis even if they know or suspect axis ii.

It could have been that or BiPolar, or PTSD, or generalized anxiety disorder, depression,  bla bla bla.  It works cause someone with an axis ii presentation is very likely to have some co-morbid symptoms anyway.  All of these are likely more insurable and easier for the client to accept,  too.

An adjustment disorder is usually just referring to a person who is having a difficult time adjusting to some kind of stressor in their life (death of loved one, loss of job, chronic bad relationship)  and it's showing up with symptoms of depression/anxiety and/or otherwise infringing on their quality of life in some way.   An ajustment disorder sounds a lot less scary than a 'personality disorder'.   Here's the thing..if you have an axis ii issue in your life...you can bet you are having some significant adjustment issues...but they are pervasive and stable over time...they are not due to just 'a stressor'.   So, it's close enough for paperwork purposes.  also...they may write down the least agressive diagnosis...knowing on their internal paperwork that it's axis ii or that they are still doing a rule-out on axis ii.  (suspect something's there but not sure yet).  The insurance company would not see that 'rule out' anyway...I think they only see what the clinician wants them to see for coverage.


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« Reply #2 on: July 09, 2011, 02:20:34 PM »

That makes a lot of sense. Thank you very much for chiming in.  Doing the right thing
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