Linden Michael, Baumann Kai, Rotter Max, Schippan Barbara
Research Group Psychosomatic Rehabilitation, Charité University Medicine Berlin, Germany.
Psychother Psychosom. 2008;77(1):50-6. doi: 10.1159/000110060. Epub 2007 Dec 14.
The term 'posttraumatic embitterment disorder' (PTED) was recently introduced to describe a subtype of adjustment disorders, characterized by prolonged embitterment, severe additional psychopathological symptoms and great impairment in most areas of life in reaction to a severe negative but not life threatening life event. The aim of this study is an empirical description and validation of the clinical concept of PTED, by comparing clinically defined PTED patients with patients suffering from other mental disorders on measures of posttraumatic stress and psychopathological distress.
Fifty inpatients, suffering from PTED according to previously defined clinical diagnostic criteria, were compared with another 50 patients, matched by age and gender, who did not meet clinical criteria for PTED but for other mental disorders. Psychiatric diagnoses were assessed by the Mini International Neuropsychiatric Interview. Self-report measures included the Bern Embitterment Scale, the Impact of Event Scale, the PTED Self-Rating Scale and the SCL-90.
According to the Mini International Neuropsychiatric Interview both groups fulfilled the criteria for many disorders with a significantly higher occurrence of major depression and chronic adjustment disorder but less generalized anxiety disorder lifetime in PTED patients. Patients with PTED scored significantly higher on the global scores and on most subdimensions of the SCL-90, the Impact of Event Scale, the Bern Embitterment Scale and the PTED Self-Rating Scale.
Clear differences were found between PTED patients and patients with other mental disorders in regard to the quality and intensity of psychopathological as well as posttraumatic stress symptoms. PTED can help further subclassify and specify adjustment and reactive disorders.
“创伤后痛苦障碍”(PTED)这一术语最近被引入,用于描述适应障碍的一种亚型,其特征为长期痛苦、严重的附加精神病理症状以及因严重负面但非危及生命的生活事件而在生活的大多数领域出现严重损害。本研究的目的是通过在创伤后应激和精神病理痛苦测量方面,将临床定义的PTED患者与患有其他精神障碍的患者进行比较,对PTED的临床概念进行实证描述和验证。
将50名根据先前定义的临床诊断标准患有PTED的住院患者与另外50名年龄和性别匹配、不符合PTED临床标准但患有其他精神障碍的患者进行比较。通过迷你国际神经精神病学访谈评估精神科诊断。自我报告测量包括伯恩痛苦量表、事件影响量表、PTED自评量表和症状自评量表(SCL - 90)。
根据迷你国际神经精神病学访谈,两组都符合多种障碍的标准,PTED患者中重度抑郁症和慢性适应障碍的发生率显著更高,但终生广泛性焦虑障碍的发生率较低。PTED患者在SCL - 90、事件影响量表、伯恩痛苦量表和PTED自评量表的总体得分及大多数子维度上得分显著更高。
在精神病理症状以及创伤后应激症状的性质和强度方面,PTED患者与其他精神障碍患者之间存在明显差异。PTED有助于进一步对适应障碍和反应性障碍进行亚分类和细化。