Reliability of the Arabic version of the ADNM-20 in cancer patients: prevalence and associated factors

Abstract Objectives Adjustment Disorder—New Module 20 (ADNM-20) is a tool used to assess the new diagnostic concept of adjustment disorder (AjD) according to the International Classification of Diseases, 11th Revision (ICD-11). This study aimed primarily to evaluate the reliability of the Arabic version of the ADNM-20, examine the prevalence and associated factors of AjD, and compare hospital and community groups. Methods A total of 146 adult cancer patients were recruited from a tertiary care center in Riyadh, Saudi Arabia, and cancer societies. Reliability was assessed using internal consistency, test–retest stability, and subscale–total correlations. AjD prevalence was determined using a cutoff score of 47.5. Associations were examined using chi-square tests and logistic regression analyses with odds ratios (ORs) and 95% confidence intervals (CIs). Results The Arabic ADNM-20 demonstrated high reliability (Cronbach’s α = 0.92; ICC = 0.76). Overall, 43.8% of participants were classified as being at high risk of AjD, with no significant difference between hospital and community groups. Female gender (OR = 2.24), unemployment (OR = 6.45), chemotherapy (OR = 10.41), exposure to two or more stressors (OR = 3.13), and financial stress (OR = 2.78) were significantly associated with AjD. Conclusion The Arabic ADNM-20 is a reliable screening tool for identifying AjD among cancer patients. Its use in oncology settings may support early detection and targeted psychosocial interventions. Further studies are recommended to establish full psychometric validation in Arabic-speaking populations.