- F43
- Anxiety Disorders
Reaction to Severe Stress and Adjustment Disorders (F43)
DSM-5-TR: Trauma- and Stressor-Related Disorders
ICD-10-AM and DSM-5-TR may classify conditions differently. Refer to APA and WHO for complete diagnostic criteria.
Key Facts
- ICD-10 RangeF40-F48
- Subcodes5 subcodes
- Australian PrevalencePTSD affects approximately 4.4% of Australian adults in their lifetime. Higher rates among veterans, first responders, and Aboriginal and Torres Strait Islander communities. Adjustment disorders are among the most common diagnoses in Australian mental health practice.
- Global PrevalencePTSD lifetime prevalence varies widely by country (1-10%), reflecting differential trauma exposure. Adjustment disorders are among the most common psychiatric diagnoses worldwide.
- Duration RequirementAcute stress reaction: hours to days. PTSD: onset within 6 months of trauma, symptoms persist beyond 1 month. Adjustment disorder: within 1 month of stressor onset, resolves within 6 months after stressor ends.
Overview
This category differs from others in that it includes disorders identified on the basis of two criteria: an exceptionally stressful life event producing an acute stress reaction, or a significant life change leading to continued unpleasant circumstances that result in an adjustment disorder. The disorders in this category are thought to arise as a direct consequence of the event or ongoing stress.
Diagnostic Criteria (ICD-10)
Core Features
- Identified exceptionally stressful life event (acute stress reaction) or significant life change (adjustment disorder)
- Disorder arises as a direct consequence of the stressor
- PTSD: re-experiencing, avoidance, hyperarousal following a traumatic event
- Acute stress reaction: transient symptoms following exceptional stress
- Adjustment disorder: emotional or behavioural disturbance following a significant life change
Duration Acute stress reaction: hours to days. PTSD: onset within 6 months of trauma, symptoms persist beyond 1 month. Adjustment disorder: within 1 month of stressor onset, resolves within 6 months after stressor ends.
Exclusion Criteria
- Anxiety not related to specific stressor (use F40/F41)
- Bereavement reaction within normal range (use Z63.4)
ICD-10-AM Subcodes
| Code | Name | Description |
|---|---|---|
| F43.0 | Acute stress reaction | A transient disorder developing in response to exceptional physical or mental stress, usually subsiding within hours or days. Symptoms include initial daze, narrowed attention, inability to process stimuli, and disorientation. |
| F43.1 | Post-traumatic stress disorder (PTSD) | Arises as a delayed or protracted response to a stressful event of an exceptionally threatening or catastrophic nature. Typical features include repeated reliving of the trauma, avoidance, emotional numbing, and hyperarousal. |
| F43.2 | Adjustment disorders | States of subjective distress and emotional disturbance arising in the period of adaptation to a significant life change or stressful life event, interfering with social functioning and performance. |
| F43.8 | Other reactions to severe stress | Other specified reactions to severe stress. |
| F43.9 | Reaction to severe stress, unspecified | Unspecified reaction to severe stress. |
Classification Boundaries
Includes
- Acute stress reaction
- PTSD
- Adjustment disorders
- Culture shock
- Grief reaction
- Hospitalisation in children
Excludes1 (coded elsewhere)
- Anxiety disorders not linked to specific stressor (F40, F41)
Australian Clinical Context
Trauma and stress-related disorders are highly prevalent in Australia, with particular relevance to veterans (via DVA services), first responders, Aboriginal and Torres Strait Islander communities, and survivors of natural disasters. Phoenix Australia (formerly the Australian Centre for Posttraumatic Mental Health) provides evidence-based treatment guidelines. The PCL-5 and PC-PTSD-5 are recommended screening tools.
Medicare (MBS) Pathways
Better Access to Mental Health Care
The primary Medicare pathway for mental health treatment in Australia. Requires a GP Mental Health Treatment Plan (MHTP) referral. Available for any clinically diagnosed mental disorder.
10 individual + 10 group sessions per calendar year
| Provider Type | MBS Items | Session Type |
|---|---|---|
| Clinical Psychologist | 80000–80025 | Psychological therapy (higher rebate) |
| Registered Psychologist | 80100–80123 | Focused psychological strategies |
| Occupational Therapist | 80125–80145 | Focused psychological strategies |
| Social Worker | 80150–80175 | Focused psychological strategies |
| Psychiatrist | 291, 296–299, 300–308 | Psychiatric consultation |
GP referral items: 2700, 2701, 2715, 2717
Eligibility: Any clinically diagnosed mental disorder as defined by WHO ICD-10 Chapter V. Requires a GP or psychiatrist referral.
Exclusions:
- Intellectual disability (use Complex Neurodevelopmental Disorder pathway or specialist referral)
- Dementia and organic mental disorders (use specialist referral pathway)
- Tobacco use disorder
Grounded Scribe suggests the right MBS item codes from your recording so you can claim accurately without re-keying.
Reference information sourced from MBS Online (mbsonline.gov.au). Item availability, rebates, and eligibility criteria may change. This is not billing advice — always verify current items before claiming. Last verified: April 2026.
Clinical Documentation Notes
PTSD (F43.1) maps to Posttraumatic Stress Disorder in DSM-5-TR. Note that DSM-5-TR has separate categories for Acute Stress Disorder and Adjustment Disorders. Document the specific trauma, symptom clusters (re-experiencing, avoidance, negative cognitions/mood, hyperarousal), duration, and functional impact. Complex PTSD is recognised in ICD-11 but not explicitly in ICD-10-AM.
Related Assessment Tools
Other validated instruments commonly used alongside the Reaction to Severe Stress and Adjustment Disorders (F43).
- PCL-5
Trauma & PTSDA 20-item self-report measure assessing the 20 DSM-5 symptoms of PTSDCalculate → - PC-PTSD-5
Trauma & PTSDA 5-item screening tool designed for use in primary care to identify individuals who may benefit from further PTSD evaluationCalculate → - LEC-5
Trauma & PTSDA 17-item screening measure to identify potentially traumatic events in a respondent's lifetime. Companion measure to the PCL-5.Calculate → - ACE
Trauma & PTSD10-item screening for adverse childhood experiences (before age 18)Calculate → - DASS-21
StressA 21-item self-report measure of depression, anxiety, and stress with three 7-item subscalesCalculate →
Related Diagnostic Codes
ICD-10-AM diagnostic codes commonly associated with the Reaction to Severe Stress and Adjustment Disorders (F43).
Frequently Asked Questions
How do I distinguish PTSD from an adjustment disorder?
PTSD (F43.1) requires exposure to a traumatic event of exceptionally threatening or catastrophic nature and specific symptom clusters. Adjustment disorders (F43.2) arise from less severe stressors (e.g., relationship breakdown, job loss) and symptoms do not meet full PTSD criteria. Adjustment disorders typically resolve within six months of the stressor ending.
What about Complex PTSD?
Complex PTSD is formally recognised in ICD-11 but not in ICD-10-AM or DSM-5-TR. In ICD-10-AM, complex trauma presentations are typically coded as F43.1 (PTSD) with co-occurring personality changes (F62.0) or other relevant codes as needed. The ITQ (International Trauma Questionnaire) can help identify complex PTSD features.
References
- World Health Organization. ICD-10-AM.
- Phoenix Australia. Australian Guidelines for the Prevention and Treatment of Acute Stress Disorder, Posttraumatic Stress Disorder and Complex PTSD.
- American Psychiatric Association. DSM-5-TR. 2022.
This tool calculates scores based on published guidelines for professional reference. It does not provide clinical diagnoses. Scores are provided as reference information only and should be interpreted by a qualified practitioner in the context of a comprehensive assessment.
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