Prevalence and Predictors of Adjustment Disorder among Postgraduate Medical Residents in Puducherry

Abstract

Background: Adjustment disorder is a stress-related mental health problem caused by emotional and
behavioural reaction to identified stressors. Post-graduate medical residents facing work overload, academic
pressure and perpetual stress states. Nonetheless, region specific for Puducherry is still limited.
Aim and Objective: To determine the prevalence and predictors of adjustment disorder among postgraduate
medical residents in Puducherry and to assess their coping mechanisms.
Methods: A cross-sectional study was conducted among 410 postgraduate medical residents from the batches
of 2022 and 2023 across medical colleges in Puducherry. Participants were selected using probability
proportional to size sampling. Data were collected using a pre-validated semi-structured questionnaire MAD-
MEDS scale© modified from ADNM 20 and DSM-5 criteria, assessing demographic details, Academic and
Clinical stressors, emotional, cognitive, behavioural symptoms, and coping mechanisms using Frequency-
based Likert scale. Data were analysed using IBM SPSS version 27. Descriptive statistics, Chi-square test, and
multivariable logistic regression were applied to find the association.
Results: The prevalence of adjustment disorder was 44.6% containing high and severe distress, with 48.3% at
moderate distress showing at risk of adjustment disorder. Academic and workload stress had the highest mean
score, followed by emotional, cognitive, and behavioural domains. Significant predictors included increasing
age (AOR=2.156; 95% CI: 1.03–4.52), female gender (AOR=4.034; 95% CI: 1.69–9.63), and year of study,
with senior residents having lower odds (AOR=0.196; 95% CI: 0.046–0.84). Common symptoms among the
residents include emotional exhaustion, irritability, poor concentration, and social withdrawal. Postgraduates
follow coping strategies like mindfulness practices, peer discussion, and supportive work environments.
Conclusion: A high proportion of postgraduate residents experience adjustment disorder, mainly resulted by
academic and workload stress. Early identification, structured mentorship, workload optimization, and
institutional mental health support systems are essential to improve resident well-being.