Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital of Ruhr-University Bochum, Bochum, Germany.
Department of Psychiatry, Ruhr-University Bochum, LWL-University Hospital, Alexandrinenstr.1, 44791, Bochum, Germany.
BMC Psychiatry. 2023 Mar 8;23(1):146. doi: 10.1186/s12888-023-04642-x.
Embitterment is a persistent emotion that is known to everybody in reaction to injustice and being let down, associated with feelings of helplessness and hopelessness. People with psychiatric disorders can develop bitterness, which is to be understood as a form of reactive embitterment to the illness. The aim of this explorative study was to investigate the occurrence of embitterment in obsessive-compulsive patients compared to healthy volunteers and in the context of their metacognitions and other biographical and clinical characteristics.
Following a semi-structured diagnostic interview, a number of measures were administered to 31 patients with obsessive-compulsive disorder (OCD) [ICD-10 F42.X: mean age 35.2 (SD = 10.7) years] and 31 healthy volunteers [mean age 39.1 (SD = 15.0) years]. These measures included the Post-Traumatic Embitterment Disorder questionaire (PTEDq) for measuring embitterment, the Yale-Brown Obsessive-Compulsive Scale, the Metacognition Questionnaire and other psychometric questionnaires such as the Beck Depression Inventory and the State-Trait Anxiety Inventory.
Patients with OCD scored more than three times higher (mean = 2.0, SD = 1.1) than the healthy participants in the PTEDq (mean = 0.6, SD = 0.8; p < 0.001), but the cut-off of < 2.5 for a clinically relevant embitterment disorder was not reached. Dysfunctionally distorted metacognition (MCQ-30), which is a consistent finding in OCD, as well as a generally high degree of clinical impairment were significantly cor related to the degree of embitterment.
Our findings suggest that embitterment as measured by PTEDq is important in patients with OCD, who are characterized by metacognitive distortions with an injustice of fate as well as a mortification of their self-image. In future, it would be necessary to screen patients with OCD not only for depressive symptoms but also specifically for feelings of embitterment in order to be able to initiate appropriate psychotherapeutic measures at an early stage.
痛苦是一种持久的情绪，每个人在面对不公和失望时都会产生这种情绪，它与无助和绝望感有关。患有精神障碍的人可能会产生痛苦，这种痛苦可以被理解为对疾病的一种反应性痛苦。本探索性研究的目的是调查强迫症患者与健康对照组相比，以及在他们的元认知和其他传记和临床特征的背景下，痛苦的发生情况。
在进行半结构化诊断访谈后，对 31 名强迫症患者（ICD-10 F42.X：平均年龄 35.2（SD=10.7）岁）和 31 名健康志愿者（平均年龄 39.1（SD=15.0）岁）进行了多项测试。这些测试包括创伤后痛苦障碍问卷（PTEDq），用于测量痛苦；耶鲁-布朗强迫量表；元认知问卷和其他心理测试问卷，如贝克抑郁量表和状态-特质焦虑量表。
强迫症患者在 PTEDq 上的得分（平均=2.0，SD=1.1）是健康对照组的三倍以上（平均=0.6，SD=0.8；p<0.001），但没有达到临床相关痛苦障碍的<2.5 分的截断值。在强迫症中一致存在的功能失调扭曲的元认知（MCQ-30），以及普遍较高的临床损害程度，与痛苦的程度显著相关。
我们的研究结果表明，PTEDq 测量的痛苦在强迫症患者中很重要，这些患者的特点是存在命运不公和自我形象受损的元认知扭曲。在未来，不仅要对强迫症患者进行抑郁症状的筛查，还要专门对他们的痛苦感进行筛查，以便能够在早期阶段启动适当的心理治疗措施。
