目的：本研究欲了解精神科門診以適應障礙為初診斷之役男，6個月後診斷改變的情形，其所具有之特徵，以及合併自殺傾向、物質使用的情形。方法：透過某國軍醫院精神科門診，收集初診斷為適應障礙之役男共78位，經追蹤後，符合純粹適應障礙役男57位，另收集適應正常役男55位，分屬實驗組及對照組，進行比較分析。結果：經追蹤後有10位第一軸診斷發生改變，另有11位併有第二軸之診斷。其餘診斷適應障礙和適應正常之役男在年齡、軍階、婚姻狀況、家庭經濟狀況、入伍後物質使用經驗、入伍前服役意願、入伍後服役意願、並無顯著差異。然而，適應障礙役男比適應正常者有較高頻率之：1) 入伍前自我傷害想法、計劃、及行為；2)入伍後自我傷害想法、計劃、及行為；3)不假離營想法、計劃、及行為；4)入伍前曾接受專業輔導、以及入伍後接受部隊的輔導；6) 家人支持度較差，與家人的互動關係也較不親密；7)入伍前物質使用經驗較多、入伍後休假歸營意願較低。此外，適應障礙役男之身心症狀總數、身心症狀嚴重指標、身心症狀困擾指標亦較高。結論：本研究發現部份役男之適應障礙診斷經追蹤後有改變的情形，而且此一診斷之役男合併有較高之自傷、自殺傾向，物質使用經驗，以及身心症狀，造成個人及部隊的困擾，值得臨床重視。

　　　　　Objective: The purpose of this study was to investigate diagnostic stability, clinical characteristics and comorbidities in soldiers with adjustment disorder. Methods: Seventy-eight outpatient soldiers with an initial diagnosis of adjustment disorder were recruited and followed for six months. After follow-up, their Axis I and II diagnoses were reviewed and 57 soldiers had their diagnosis of Adjustment Disorder confirmed, based on meeting the relevant criteria. Another 55 matched soldiers without any adaptation difficulty in the army were used as controls. Several clinical variables were compared, including comorbidities between the control and study groups. Results: Ten of the 78 patients with an initial diagnosis of adjustment disorder had their Axis I diagnoses changed after six-months' follow-up. Eleven patients were found to have Axis II diagnoses after follow-up. Soldiers with a pure diagnosis of adjustment disorder exhibited a significantly higher prevalence of suicidal ideation, plans, and attempts, both before and after enlisting when compared to the control group. Additionally, there was an increased frequency of ideation, planning, and attempted escape from the army. Counselling and psychological guidance was also more common both before and after enlistment. There was also a higher level of experience with substance use reported, in addition to poor family interactions and support. Subjects were less willing to return to the army after holidays, and subjects tended to have higher Positive Symptom Total (PST) , Global Severity Index (GSI) , and Positive Symptom Distress Index (PSDI) scores when compared to the control group. Interestingly, there were no significant differences in age, military rank, educational level, marital status, family situation, experiences with substance use after enlistment, and their willingness to be enlisted. Conclusion: The results of this study indicate that a diagnosis of adjustment disorder in outpatient soldiers may change after follow up and that those soldiers with a pure diagnosis of adjustment disorder have a higher tendency to suicide or self-harm, and tend to experience more psychosomatic symptoms and drug use.